0667 Enhancing Continuity of Care: PAP Provision at Discharge for Patients Diagnosed with Obstructive Sleep Apnea

Abstract Introduction Obstructive sleep apnea (OSA) is a prevalent disorder linked to significant cardiovascular, metabolic, and neurocognitive complications. Positive airway pressure (PAP) therapy is the standard treatment, but many patients diagnosed during hospitalization are discharged without timely PAP initiation, creating gaps in care and delaying therapy. Ensuring PAP provision at discharge is essential for improving access, adherence, and continuity of care. This quality improvement project evaluates current discharge practices for hospitalized patients diagnosed with OSA and aims to identify opportunities to increase appropriate PAP provision at discharge. Methods We conducted a retrospective chart review of 705 adult patients admitted to Henry Ford Hospital from January 2015 to September 2025 who received an inpatient sleep medicine consultation. Electronic medical records were reviewed to determine whether PAP therapy was prescribed and delivered at discharge. Data collected included demographics, method of diagnosis, discharge disposition, and documentation of PAP initiation or equipment orders. PAP provision rates were calculated as the proportion of eligible patients receiving PAP prior to discharge. Results Among 705 patients reviewed, 283 were diagnosed with OSA. Of these, 188 (66.4%) received PAP equipment at discharge and 95 (33.6%) did not. The absence of documented PAP initiation in one-third of eligible patients highlights variability in inpatient prescribing practices and missed opportunities for timely therapy initiation. Conclusion Only two-thirds of hospitalized patients diagnosed with OSA received PAP equipment prior to discharge, revealing a significant gap in care and opportunity to strengthen inpatient initiation of therapy. Improving PAP provision rates will require a more systematic approach, including early sleep medicine consultation, streamlined EMR-based PAP ordering workflows, coordination with primary teams, and enhanced education for both patients and clinical staff. Implementing these strategies may enhance therapy initiation, adherence, and continuity of care for hospitalized patients with OSA. Support (if any)