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Development and Implementation of Rapid Discharge Plan in a Municipal Healthcare System

2025· preprint· en· W4411841325 on OpenAlexaff
Ryan Leone, Laura Iavicoli, David M. Silvestri, R. James Salway

Bibliographic record

Venuenot available
Typepreprint
Languageen
FieldPharmacology, Toxicology and Pharmaceutics
TopicPharmacy and Medical Practices
Canadian institutionsColumbia College
Fundersnot available
KeywordsPlan (archaeology)BusinessHealth careProcess managementOperations managementEnvironmental planningEngineeringGeographyEconomic growthEconomics

Abstract

fetched live from OpenAlex

In scenarios where patient demand exceeds hospital capacity, such as natural disasters, terrorist attacks, or staffing shortages, the rapid discharge of patients who are identified through reverse triage methodologies can create surge capacity. Numerous resources and studies have evaluated this concept, but current tools tend to be extensive and siloed, which may make them difficult to use during emergencies. To prepare the largest municipal healthcare system in the United States for situations requiring rapid patient discharge, New York City Health + Hospital’s Central Office Emergency Management sought to develop a short, synthesized, and user-friendly plan. After consulting experts and reviewing existing peer-reviewed papers, gray literature, and internal facility documents, the team created a 7-page Response Action Checklist - Risk-based, Abbreviated, Patient Identification Discharge Tool (RAPID) to synthesize important content. This tool was successfully utilized during a resident labor action in May 2023, illustrating that its utility may extend beyond the system in which it was used. Future work should be done to validate and improve upon this tool.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.837
Threshold uncertainty score0.928

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.001
Research integrity0.0000.002
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.243
GPT teacher head0.535
Teacher spread0.292 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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