{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T04:28:20Z","timestamp":1767155300804,"version":"3.38.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Syst"],"DOI":"10.1007\/s10916-025-02164-5","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T04:21:45Z","timestamp":1740457305000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Most Weekday Discharge Times at Acute Care Hospitals in the State of Florida Occurred After\u00a03\u00a0PM in 2022, Unchanged from Before the COVID-19 Pandemic"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8466-3845","authenticated-orcid":false,"given":"Richard H.","family":"Epstein","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5897-2484","authenticated-orcid":false,"given":"Franklin","family":"Dexter","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5248-5164","authenticated-orcid":false,"given":"Brenda G.","family":"Fahy","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"key":"2164_CR1","first-page":"283","volume":"17","author":"TW Zollinger","year":"1999","unstructured":"Zollinger TW, Saywell RM Jr, Smith CP, Highland D, Pfeiffer B, Kelton GM., Delays in patient transfer: Postanesthesia care nursing. Nursing Econ. 1999;17:283-290.","journal-title":"Nursing Econ."},{"key":"2164_CR2","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.jopan.2012.05.013","volume":"27","author":"B Cowie","year":"2012","unstructured":"Cowie B, Corcoran P. Postanesthesia care unit discharge delay for nonclinical reasons. J Perianesth Nurs. 2012;27:393-398.","journal-title":"J Perianesth Nurs."},{"key":"2164_CR3","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/s10916-019-1496-x","volume":"44","author":"RH Epstein","year":"2020","unstructured":"Epstein RH, Dexter F, Diez C. The distributions of weekday discharge times at\u00a0acute care hospitals in\u00a0the state of Florida were static from 2010 to 2018. J Med Syst. 2020;44:47.","journal-title":"J Med Syst."},{"key":"2164_CR4","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1136\/bmjqs-2011-000243","volume":"21","author":"JM Glasgow","year":"2012","unstructured":"Glasgow JM, Davies ML, Kaboli PJ. Findings from a national improvement collaborative: are improvements sustained? BMJ Qual Saf. 2012;21:663-669.","journal-title":"BMJ Qual Saf."},{"key":"2164_CR5","unstructured":"Agency for Health Care Administration. AHCA Patient Data Submission Guide. https:\/\/ahca.myflorida.com\/content\/download\/6087\/file\/DataGuideUpdate071119.pdf. Accessed 19\u00a0December 2024."},{"key":"2164_CR6","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1007\/s10916-015-0232-4","volume":"39","author":"JR Starnes","year":"2015","unstructured":"Starnes JR, Wanderer JP, Ehrenfeld JM. Metadata from data: Identifying holidays from anesthesia data. J Med Syst. 2015;39:44.","journal-title":"J Med Syst."},{"key":"2164_CR7","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1213\/ANE.0000000000000773","volume":"121","author":"F Dexter","year":"2015","unstructured":"Dexter F, Dutton RP, Kordylewski H, Epstein RH. Anesthesia workload nationally during regular workdays and weekends. Anesth Analg. 2015;121:1600-1603.","journal-title":"Anesth Analg."},{"key":"2164_CR8","doi-asserted-by":"publisher","first-page":"100076","DOI":"10.1016\/j.pcorm.2019.100076","volume":"16","author":"F Dexter","year":"2019","unstructured":"Dexter F, Epstein RH, Rodriguez LI. Throughout the United States, pediatric patients undergoing ambulatory surgery enter the operating room and are discharged earlier in the day than are adults Perioper Care Oper Room Manag. 2019;16:100076.","journal-title":"Perioper Care Oper Room Manag."},{"key":"2164_CR9","unstructured":"Steiner CA, Karaca Z, Moore BJ, Imshaug MC, Pickens G. Surgeries in hospital-based ambulatory surgery and hospital inpatient settings, 2014. HCUP Statistical brief #223, updated 20 July 2020. https:\/\/hcup-us.ahrq.gov\/reports\/statbriefs\/sb223-Ambulatory-Inpatient-Surgeries-2014.jsp Accessed 19\u00a0December 2024."},{"key":"2164_CR10","first-page":"e9746","volume":"12","author":"RH Epstein","year":"2020","unstructured":"Epstein RH, Dexter F, Smaka TJ, Candiotti KA. Policy implications for the COVID-19 pandemic in light of most patients (\u226572%) spending at most one night at the hospital after elective, major therapeutic procedures. Cureus. 2020;12:e9746.","journal-title":"Cureus."},{"key":"2164_CR11","doi-asserted-by":"publisher","first-page":"111596","DOI":"10.1016\/j.jclinane.2024.111596","volume":"98","author":"RH Epstein","year":"2024","unstructured":"Epstein RH, Dexter F, Fahy BG. Since the COVID-19 pandemic, approximately 90% of elective anesthetics have been ambulatory: A retrospective analysis of statewide data in Florida from 2010 through 2022. J\u00a0Clin\u00a0Anesth. 2024;98:111596.","journal-title":"J Clin Anesth."},{"key":"2164_CR12","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1111\/j.1475-6773.2011.01267.x","volume":"46","author":"ME Weiss","year":"2011","unstructured":"Weiss ME, Yakusheva O, Bobay KL. Quality and cost analysis of nurse staffing, discharge preparation, and postdischarge utilization. Health Serv Res. 46:1473-1494, 2011.","journal-title":"Health Serv Res."},{"key":"2164_CR13","doi-asserted-by":"crossref","unstructured":"Griffiths P, Dall'Ora C, Simon M, Ball J, Lindqvist R, Rafferty AM, Schoonhoven L, Tishelman C, Aiken LH; RN4CAST Consortium. Nurses' shift length and overtime working in 12 European countries: the association with perceived quality of care and patient safety. Med Care. 52:975\u2013981, 2014.","DOI":"10.1097\/MLR.0000000000000233"},{"key":"2164_CR14","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1097\/NCQ.0000000000000100","volume":"30","author":"Y Xue","year":"2015","unstructured":"Xue Y, Chappel AR, Freund DA, Aiken LH, Noyes K. Cost outcomes of supplemental nurse staffing in\u00a0a large medical center. J Nurs Care Qual. 30:130-137, 2015.","journal-title":"J Nurs Care Qual."},{"key":"2164_CR15","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1111\/jonm.12595","volume":"26","author":"M Watanabe","year":"2018","unstructured":"Watanabe M, Yamauchi K. The effect of quality of overtime work on nurses' mental health and work engagement. J Nurs Manag. 26:679-688, 2018.","journal-title":"J Nurs Manag."},{"key":"2164_CR16","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1080\/07420528.2020.1806290","volume":"37","author":"C Dall'Ora","year":"2020","unstructured":"Dall'Ora C, Ball J, Redfern OC, Griffiths P. Night work for hospital nurses and sickness absence: a\u00a0retrospective study using electronic rostering systems. Chronobiol Int. 37:1357-1364, 2020.","journal-title":"Chronobiol Int."},{"key":"2164_CR17","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.jopan.2006.07.007","volume":"21","author":"F Dexter","year":"2006","unstructured":"Dexter F, Wachtel RE, Epstein RH. Impact of average patient acuity on staffing of the phase I PACU. J Perianesth Nurs. 21:303-310, 2006.","journal-title":"J Perianesth Nurs."},{"key":"2164_CR18","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1097\/EJA.0000000000001284","volume":"37","author":"\u00c5 Idoffsson","year":"2020","unstructured":"Idoffsson \u00c5, Olsson C, Holm\u00e9n A, Granberg-Axell A, Chew MS. Development and validation of an instrument to measure nursing workload in the postanaesthesia care unit: An observational study. Eur J Anaesthesiol. 2020;37:864-873.","journal-title":"Eur J Anaesthesiol."},{"key":"2164_CR19","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1213\/01.ANE.0000056701.08350.B9","volume":"96","author":"E Marcon","year":"2003","unstructured":"Marcon E, Kharraja S, Smolski N, Luquet B, Viale JP. Determining the number of beds in the postanesthesia care unit: a computer simulation flow approach. Anesth Analg. 2003;96:1415-1423.","journal-title":"Anesth Analg."},{"key":"2164_CR20","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1097\/ALN.0b013e3181a16983","volume":"110","author":"T Schoenmeyr","year":"2009","unstructured":"Schoenmeyr T, Dunn PF, Gamarnik D, Levi R, Berger DL, Daily BJ, Levine WC, Sandberg WS. A model for understanding the impacts of demand and capacity on waiting time to enter a congested recovery room. Anesthesiology. 2009;110:1293-304.","journal-title":"Anesthesiology."},{"key":"2164_CR21","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1097\/00000539-200105000-00026","volume":"92","author":"F Dexter","year":"2001","unstructured":"Dexter F, Traub RD, Penning DH. Statistical analysis by Monte-Carlo simulation of the impact of\u00a0administrative and medical delays in discharge from the postanesthesia care unit on total patient care hours.\u00a0Anesth Analg. 2001;92:1222-1225.","journal-title":"Anesth Analg."},{"key":"2164_CR22","doi-asserted-by":"publisher","first-page":"100165","DOI":"10.1016\/j.pcorm.2021.100165","volume":"23","author":"F Dexter","year":"2021","unstructured":"Dexter F, Epstein RH. Implications of the log-normal distribution for updating estimates of the time remaining until ready for phase I post-anesthesia care unit discharge. Periop\u00a0Care\u00a0Oper\u00a0Room\u00a0Manag. 2021;23:100165.","journal-title":"Periop Care Oper Room Manag."},{"key":"2164_CR23","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1097\/00000539-200104000-00029","volume":"92","author":"F Dexter","year":"2001","unstructured":"Dexter F, Epstein RH, Penning DH. Statistical analysis of postanesthesia care unit staffing at a surgical suite with frequent delays in admission from the operating room \u2013 A case study. Anesth\u00a0Analg. 2001;92:947-949.","journal-title":"Anesth Analg."},{"key":"2164_CR24","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1053\/jpan.2002.31840","volume":"17","author":"RH Epstein","year":"2002","unstructured":"Epstein RH, Dexter F, Traub RD. Statistical power analysis to estimate how many months of data are required to identify PACU staffing to minimize delays in admission from ORs. J Perianesth Nurs.. 2002;17:84-88.","journal-title":"J Perianesth Nurs."},{"key":"2164_CR25","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.jopan.2005.01.001","volume":"20","author":"F Dexter","year":"2005","unstructured":"Dexter F, Epstein RH, Marcon E, de Matta R. Strategies to reduce delays in admission into a postanesthesia care unit from operating rooms. J Perianesth Nurs. 2005;20:92-102.","journal-title":"J Perianesth Nurs."},{"key":"2164_CR26","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1213\/ANE.0b013e3182a8b0bd","volume":"117","author":"JM Ehrenfeld","year":"2013","unstructured":"Ehrenfeld JM, Dexter F, Rothman BS, Minton BS, Johnson D, Sandberg WS, Epstein RH. Lack of\u00a0utility of a decision support system to mitigate delays in admission from the operating room to\u00a0the postanesthesia care unit. Anesth Analg. 2013;117:1444-1452.","journal-title":"Anesth Analg."},{"key":"2164_CR27","doi-asserted-by":"publisher","first-page":"100111","DOI":"10.1016\/j.pcorm.2020.100111","volume":"21","author":"SE Nelson","year":"2020","unstructured":"Nelson SE, Sandberg WS, Clifton JC, Cui Y, Shotwell MS, Wanderer JP. Holding some postoperative patients overnight in the post-anesthesia care unit as a tactic to deal with hospital congestion is associated with increased resource length of stay. Periop Care Oper Room Manag. 2020;21:100111.","journal-title":"Periop Care Oper Room Manag."},{"key":"2164_CR28","doi-asserted-by":"publisher","first-page":"534","DOI":"10.3390\/jcm13020534","volume":"13","author":"NJ Koning","year":"2024","unstructured":"Koning NJ, Lokin JLC, Roovers L, Kallewaard JW, van Harten WH, Kalkman CJ, Preckel B. Introduction of a post-anaesthesia care unit in a teaching hospital is associated with a reduced length of hospital stay in noncardiac surgery: a single-centre interrupted time series analysis. J Clin Med. 2024;13:534.","journal-title":"J Clin Med."},{"key":"2164_CR29","doi-asserted-by":"publisher","first-page":"100434","DOI":"10.1016\/j.pcorm.2024.100434","volume":"37","author":"DF Nelson","year":"2024","unstructured":"Nelson DF, Palomino C, Torjman MC, Ooi G, Green MS. Length of stay and cost of care differences between postoperative patients who board in PACU and those that proceed directly to inpatient bed. Periop Care Oper Room Manag. 2024;37:100434.","journal-title":"Periop Care Oper Room Manag."},{"key":"2164_CR30","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1097\/00000542-200308000-00032","volume":"99","author":"F Dexter","year":"2003","unstructured":"Dexter F, Wachtel RE, Yue JC. Use of discharge abstract databases to differentiate among pediatric hospitals based on operative procedures: Surgery in infants and young children in the State of Iowa. Anesthesiology. 2003;99:480-487.","journal-title":"Anesthesiology."},{"key":"2164_CR31","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s12630-017-0993-y","volume":"65","author":"JD O\u2019Leary","year":"2018","unstructured":"O\u2019Leary JD, Dexter F, Faraoni D, Crawford MW. Incidence of non-physiologically complex surgical procedures performed in children: an Ontario population-based study of health administrative data. Can\u00a0J\u00a0Anesth. 2018;65:23-33.","journal-title":"Can J Anesth."}],"container-title":["Journal of Medical Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10916-025-02164-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10916-025-02164-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10916-025-02164-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T04:21:48Z","timestamp":1740457308000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10916-025-02164-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,25]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2164"],"URL":"https:\/\/doi.org\/10.1007\/s10916-025-02164-5","relation":{},"ISSN":["1573-689X"],"issn-type":[{"value":"1573-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,25]]},"assertion":[{"value":"21 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Division of Management Consulting of the University of Iowa\u2019s Department of Anesthesia provides consultations to corporations and hospitals. Dr. Dexter receives no funds personally other than his salary and allowable expense reimbursements from the University of Iowa and has tenure with no incentive program. He and his family have no financial holdings in any company related to his work other than indirectly through mutual funds for retirement. Income from the Division's consulting work is used to fund Division research. A list of all the Division\u2019s consults is available in his posted curriculum vitae at .","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"On January 30, 2024, the University of Miami Institutional Review Board determined that this research does not meet the regulatory definition of human subjects research.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"None required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics and Consent to Participate"}}],"article-number":"31"}}