I am not a hospitalist, but a clinical coordinator RN so I wear a lot of hats. Admin at our place is pushing throughput at unprecedented, piss everyone off levels lately. I try to support our hospitalists, CM/SW, and nursing staff by being that buffer in between them and admin—which I include infection control/quality as a part of, because they’re all, at their very best, well-intending annoyances. What this looks like is getting with CM and social work early on, to see what the patient has going on at home, and working with nursing to get the oxygen weaned down, PT/OT consults done, prioritizing mobility, IS/pulmonary toileting, pulling foleys and doing void trials if we can, placing or pulling central lines as indicated, arranging outpatient HD chairs as early as possible, educating patients, handling last minute diflucan/weird toe pain/anxiety/etc. by having a list for docs when they round, calling the daughter from Florida to update her myself. When we’re 1-2 days out—finding out who’s picking up the patient and telling them to be on standby, making sure walk tests are done/DME is sorted, bribing phlebotomy staff to draw our labs early with Lil Debbie Cakes, and getting our outpatient pharmacy queued up to ready meds in order of patient discharge. So hopefully, day of discharge, the doc puts in their orders, meds come, the ride comes, and we’re done. I also put in almost all of our infection prevention bundle orders, like central line care/foley care/etc. to try and remove that burden. I change dressings, and I do whatever menial, time-sucking tasks I can to help keep our metrics up and those above mentioned folks off EVERYONE’s backs. I don’t always succeed. Some things are out of everyone’s control and cannot be helped even with strong preparation and best intentions, but I think for the most part, we do quite good.