🏥 EarlyDC

Complete User Manual - Patient Discharge, Transfers, and Analytics System

Version 1.0 | Last Updated: 2025

📑 Table of Contents

1. Introduction

Welcome to EarlyDC, a comprehensive web application designed to modernize and standardize patient discharge workflows, reduce delays, and deliver actionable analytics for hospital flow optimization. EarlyDC integrates with Oracle EMR (or a mock API for testing), centralizes data entry, and exposes rich operational metrics.

Key Capabilities

  • 🔄 Real-time synchronization of active patients from Oracle EMR
  • 🧭 Dashboard with filters to focus daily work
  • 📝 Patient disposition: discharge or transfer with clinical/physical timestamps
  • ⏱️ EDC (Early/Timely Discharge Candidate) validation and draft workflows
  • 🧩 Grouped delay reasons with configurable catalog
  • 📈 Analytics: team performance, temporal patterns, LOS, EDC success, transfers
  • 🔐 Role-based access with audit-friendly data structures

Audience: Clinical teams, bed managers, quality leads, and IT administrators.

2. Getting Started

2.1 Logging In

  1. Open the application URL in your browser
  2. Enter your username and password
  3. Click Sign In
Forgot password? Contact a Super User to reset it.

2.2 Navigation

  • Dashboard – Daily view and quick actions
  • Discharges – Historical discharge records and filters
  • Failed Attempts – EDC attempts that didn’t meet targets
  • Transfers – Transfer out records and analytics
  • Reports – Comprehensive analytics
  • Settings – Admin-only configuration and user management
  • Logout – End your session securely

3. User Roles & Permissions

👑 Super User (Administrator)

  • Manage users (create/update/deactivate, reset passwords)
  • Configure delay reasons and transfer locations
  • View system status and initiate Oracle sync
  • Full access to discharges, transfers, reports

👤 Regular User

  • Work with dashboard, patient disposition, discharges, reports
  • No access to admin settings

4. Dashboard & Active Patients

The dashboard presents active patients and key statistics with filters to focus work. Typical filters include date/range, team, search, flags, LOS status, time period, and time-to-DC (by page).

Common Actions

  • Open a patient to complete discharge or transfer
  • Review LOS and team assignments; update inline from dedicated pages
  • Use filters to segment by team, time, or flag status

5. Patient Detail & Disposition

The Patient Detail page presents MRN, age, diagnosis, admission date, LOS, expected LOS, team, and doctor; and a Disposition form to Discharge or Transfer.

5.1 Discharge Flow

  1. Select Discharge Patient
  2. Enter Clinical DC by MD and Ward DC by RN
  3. Click Refresh Alshifa Timestamps to auto-fill times if needed
  4. Enter Physical Discharge Time
  5. Select Delay Reasons (grouped by category). If “No Delay” applies per flag/time rules, others are disabled
  6. Provide Other Reason text if the “Other reasons” option is chosen
  7. Optionally Save Draft, or Complete Discharge
Timestamp validation: If user-entered times differ from Alshifa by >2 hours, you’ll be prompted to proceed or reset to Alshifa values.

5.2 Transfer Flow

  1. Select Transfer Patient
  2. Choose Transfer Date & Time, Location, and optional Other Location
  3. Enter Transfer Notes as needed
  4. Click Transfer Patient

5.3 Drafts & EDC Validation

  • If a draft exists, the form auto-fills your previous entries; you may refresh timestamps manually
  • If an EDC attempt is pending for today, the page requires documenting reasons for the failed attempt before discharge
  • “No Delay” selection is guided by EDC flag and discharge time windows

6. Discharges

The Discharges page lists records for a selected date or date range with rich filtering.

  • Columns: Patient, MRN, Team, Clinical DC MD/RN, Physical DC, Time to DC, LOS vs Expected, Had Flag, Flag Met, Delay Reasons, Actions
  • Filters: date/range, team, flag status (had/no/early/timely), flag success (success/failed), LOS status (shorter/expected/longer), time period, time to DC, search
  • Action: delete a discharge record (with confirmation)

7. Failed Discharge Attempts

Analyze failed EDC attempts, reasons, and timing.

  • Columns: Patient, MRN, Team, Planned Date, Actual Time, Original Flag, Discharge Flag, Discharge Success, Delay Reasons, Other Reason, Unflagged By, Timing Status, Actions
  • Filters: team, search, original flag, original success, discharge flag, discharge success, delay reason, timing status (on-time/delayed/not discharged), days since

8. Transfers

View and filter transfer out records by date range, team, location, and recency.

  • Columns: Patient, MRN, Team, Transfer Date/Time, Location (with other-text as needed), Notes, Days Since Transfer, Transferred By, Actions

9. Reports & Analytics

Use the Reports page to access multi-dimensional analytics; optionally filter by team.

9.1 Discharge Overview

  • Total, Early (before 12:00), Timely (configurable window), Delayed discharges
  • Readmissions, Average LOS, MD early documentation, Unflagged early/delayed

9.2 EDC Analytics

  • Successful vs failed early discharges; failed reasons (counts)
  • Team EDC stats: successful attempts, failed attempts, unflagged early/delayed, readmissions, avg LOS, total discharges
  • Trends by day of week (successful vs failed)

9.3 Team Performance

  • Per-team: total discharges, early/delayed by flag type, readmissions, unflagged early/delayed, MD early documentation, avg LOS, unique patients

9.4 Temporal Analysis

  • By day of week: totals, early, delayed, readmissions, unflagged early/delayed, MD early documentation
  • By time of day: Morning/Afternoon/Evening/Night discharge counts
  • Monthly trends: total discharges, early discharges, average LOS

9.5 Operational Efficiency

  • Timing efficiency: before vs after 12 PM, average minutes clinical MD → physical DC
  • Delay duration: avg hours clinical MD → physical DC where delays are documented
  • Documentation completeness: presence of clinical DC MD/RN, physical DC, and delay documentation

9.6 Patient Demographics

  • Age groups: discharges, early, delayed, unflagged early/delayed, MD early documentation, avg LOS
  • Top diagnoses: discharges, early, delayed, unflagged early/delayed, MD early documentation, avg LOS, readmissions

9.7 Delay Reasons

  • Flat list: count per reason across the selected range
  • Grouped by category with titles, icons, colors and per-reason breakdowns

9.8 Transport Analytics

  • Totals, unique locations, avg LOS before transfer, time-of-day splits
  • Location breakdown, team transfer performance, critical care (HD/PICU), recent activity
Exports: The UI includes CSV/Excel export entry points. Connect these to your preferred export formatter to generate files.

10. Settings (Admin)

Only Super Users can access Settings.

10.1 User Management

  • Create users with role and team assignment
  • Edit user profile, role, team, activation status
  • Reset passwords; deactivate users (soft-delete)

10.2 System Information

  • App name, version, timezone, last sync, counts

10.3 Team Management

  • View teams (code, name, status)
  • Note: Patient records reference teams.id; ensure Oracle UNITID is mapped to a valid team ID

10.4 Transfer Locations

  • View configured locations, status, sort order

10.5 Delay Reasons

  • Add new reasons (code + text), edit, activate/deactivate

11. Sync with Oracle EMR

From Settings, Super Users can trigger Sync Patients from Oracle EMR.

  • New patients are inserted (status new), existing updated (old)
  • Patients missing from Oracle today are flagged as undisposed locally
  • Sync timestamps are recorded and displayed
  • Team Mapping: Ensure Oracle UNITID → teams.id mapping (e.g., 240→140, 241→141, 242→142). Unmapped becomes null

12. Security & Access

  • Session-based auth with bcrypt password hashing
  • Role checks on each page; admin-only settings
  • Login attempts tracked; lockout enforced
  • Use HTTPS in production; restrict DB access

13. Troubleshooting

13.1 Sync Errors (FK)

Problem: Cannot add/update child row (patients.team_id FK).
Fix: Map Oracle UNITID to valid teams.id (e.g., 240→140, 241→141, 242→142) and ensure teams are seeded.

13.2 No Patients after Sync

  • Verify Oracle API connectivity and credentials
  • Check api_logs entries

13.3 Timestamps Not Matching

  • Use Refresh Alshifa Timestamps
  • Accept or reset if difference >2 hours

13.4 Missing Analytics

  • Confirm records exist in the selected range
  • Confirm DB schema fully applied

13.5 Performance

  • Review indexes in database/schema.sql; check server resources

14. FAQ

  • Can I use this without Oracle? Yes—enable the mock API (JSON-backed) for demos/testing
  • Can we change what “early” means? Yes—thresholds are defined in code for EDC logic
  • How do I export to Excel/CSV? The UI provides entry points; wire to your preferred export library
  • How are ages handled? Ages are normalized to months for consistency

15. Glossary

  • EDC: Early/Timely Discharge Candidate
  • LOS: Length of Stay
  • Clinical DC: Recorded by MD/RN in EMR
  • Physical DC: Time the patient physically leaves

EarlyDC User Manual

Version 1.0 | Last Updated: 2025

For technical support, contact your system administrator.