pMD Named A 2020 Best Small & Medium Workplace™ by Great Place to Work® and Fortune. Getting the right patient to the right bed at the right time can reduce LOS. This article is an investigation into the relationship between length of stay and readmission within … U.S. hospital stays cost the health system at least $377.5 billion per year. Potential Implementation Challenges: Most hospitals already have some patient placement system based on rules of thumb. 1 - 3 Hospital length of stay (HLOS) has been shown to predict functional decline for older adults, with longer HLOS associated with a greater likelihood of decline. A primary goal of the initiative is decreasing hospital length of stay, which has dropped about 1.5 days for SOAR patients. Potential Implementation Challenges: Certain areas will be required to have an increase in hours of operation, requiring a significant cultural change and perhaps the hiring of additional staff. Hospitals typically prioritize clinically urgent cases in the lab queue; less urgent cases are usually first-come, first-served. Hospital-led efforts to reduce the amount of time older people spend on wards before being allowed home can be effective, reducing length of stay in hospital by more than three days in some areas. Hospital length of stay and readmission: an early investigation. Reducing hospital length of stay (LOS), especially as it relates to avoiding unnecessary hospital-acquired conditions (HACs), is a primary … Once the data is readily available, health systems can then act to improve it, taking on projects such as selecting specific DRGs to target for improvement and starting conversations between providers and coders when benchmarks don’t seem clinically accurate. Potential Implementation Challenges: After establishing the correct unit sizes, management needs to formulate the implementation details in terms of geography and team assignment. Detecting future spikes in the census allows hospitals to staff accordingly and balance elective admissions with spikes in ED volume. The current analysis evaluated the potential economic impact of this half-day reduction in LOS. BMC Health Serv Res. several hospital departments, Mekhjian and colleagues. We’re all ears. At the end of a patient’s stay, there are many avoidable delays in discharge, such as issues with insurance documentation, transport delay and lack of space at a specialized nursing facility. When clinically viable, reducing hospital length of stay has been proven to provide both positive results for patients and financial benefits for the institution. Reducing length of stay; Reducing length of stay. We emphasized the importance of strengthening the uninvolved lower limb, and administered stand-up and sit-down exercises 400-600 times per day. One of the best ways to improve a hospital’s financial margin is to reduce the average patient length of stay. They begin looking at how length of stay is measured and why it is important. The process of admitting patients from the ED is time-intensive, highly variable and frequently leads to delays. Guide to reducing long hospital stays June 2018 . Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology. PATIENTS AND METHODS Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. Use Predictive Discharge Planning to Focus Case Teams. 1. Additional incentives may need to be introduced. For example, if a 300-bed hospital with an average LOS of four days was able to reduce the average LOS by five percent (i.e., by five hours), they could treat over 1,350 more patients each year. In the end, the patient benefits from a more. Since hospitals are paid by the “DRG” (diagnosis related group), the hospital is going to get paid the same amount for a patient with say, pneumonia, if that patient spends 4 days in the hospital or spends 8 days in the hospital. Potential Implementation Challenges: Due to its clinical nature, this problem requires approval from an expert, and it is unlikely that an analytic system can identify candidate patients/procedures with the confidence level required. June 27, 2019 . These delays could be avoided if case managers were alerted to the problem earlier in the patient’s stay. The surgical unit at Mercy Hospital is trying to reduce costs and length of stay for patients. Solution: Identify which areas are having an impact and open them for a half-day on Saturday. As of July 1, LinkedIn will no longer support the Internet Explorer 11 browser. Most hospitals employ a general approach to physician rounding with the activity usually occurring in the late morning or early afternoon. There is a need to better understand the diverse literature on reducing the length of hospital stay. If you’d like to discuss your organization’s current initiatives and goals around length of stay, reach out to us! In today’s value-based care environment, hospitals are under increasing pressure to avoid patient harm and maintain quality while also lowering costs. In this regard, there is a limit to how low the hospital length of stay index can safely go. Updating the system to include priority for patients close to discharge is not likely to be a major issue. 5 documented a decreased length of stay overall at one of the study hospitals, from 3.91 days to 3.71 days (p=0.02); however, the length of stay at the other hospital in the study did not change significantly—3.68 days to 3.61 days; p=0.356). Background. In my opinion, for most hospitals, a length of stay index of 0.80 – 0.95 is optimal. … 4 P. 10. The benefits of reducing the time a patient occupies a hospital bed are clear, ... Where to focus for maximum impact on reducing length of stay* The benefits of reducing hospital bed occupancy are clear, but achieving it has proven difficult, particularly during winter. 36. Ashby J, Guterman S, Greene T. An analysis of hospital productivity and product change. collaborative care planning initiative that takes full advantage of all available information and includes options for care outside of the inpatient environment. For example, CMS utilizes MS-DRGs (Medicare Severity Diagnosis Related Groups) to assign a specific GMLOS to each DRG in their system. The longer a patient stays in the hospital, the greater the risk they will develop a healthcare-acquired infection (HAI) that they can become vulnerable to. This approach leads to simpler patient placement and makes it easier to co-locate patients assigned to a given clinical team. Although to many, long inpatient stays may seem like the recipe for optimal patient outcomes, research shows that longer length of stay not only raises the cost for the patient and the facility, but more importantly increases the risk that the patient is exposed to unnecessary hospital acquired conditions (HACs). Also, breaking the day into useful segments allows for better tactical planning. There is evidence that establishing a specialist or designated unit within the hospital can improve length of stay, reduce mortality and reduce costs (Rimar and Diers, 2006; Czaplinski and Diers, 1998). The two units where the solution was first launched have documented 0.3 and 0.5 days reductions in length of stay. By this, length of stay in a rehabilitation hospital has become shorter, FIM … Evaluation of the costs and benefits of reducing time in hospital must start from the objectives that govern the change. Also, as new units are opened, they will need to be assessed in the same spirit. A Clarke, Length of in-hospital stay and its relationship to quality of care, Quality and Safety in Health Care, 2002, 11(3):209-10. Longer than similar patients stay at other academic medical centers. He is an avid squash player and has been named by Becker's Hospital Review as one of the top entrepreneurs innovating in healthcare. A summary view of ED activity allows users to quickly view the number of patients waiting for a bed, average boarding times, etc. Prolonged lengths of stay in hospital is a major factor in thromboembolic events and hospital-acquired infections. The organization embraced the … A unit view displays the number of occupied, dirty and available beds. The ALOS refers to the average number of days that patients spend in hospital. You’ll capture charges and patient data more accurately right at the point of care, and stay legal, thanks to our HIPAA-compliant texting and data capture platform. When do you need the evidence report? Benchmarking and reducing length of stay in Dutch hospitals. Reduce variation in practices by developing both an order set and interdisciplinary pathway, and educating physicians and hospital staff in their use. This website uses cookies to improve service and provide tailored ads. Smooth Patient Flow from the Operating Room (OR). Solution: Take simple measures such as maintaining a list of patients that can likely be discharged early and have a team round on these patients early the following morning. However, due to the diversity of patient conditions, much of the literature focuses on a very specific class of patient (e.g., patients with acute kidney damage). Measures to reduce the length of hospital stay are among the main approaches to enhance a hospital's operational efficiency. Cont’d, P.g 2 Who knows better than the clinical providers on each patient unit how to improve care and thereby reduce the LOS (Studies have shown that quality In some cases, it is more cost-effective to schedule certain procedures as outpatient rather than inpatient, particularly if the patient is local. Reducing Length of Stays in Hospitals. – while waiting for a hospital bed • Fewer patients being denied transfer to tertiary/quaternary care hospitals because the "hospital is full" • Fewer ambulance diversions for special populations • Improved patient and provider satisfaction related to care planning. 4 - 6 HLOS has been decreasing in recent decades. 5 Minutes. In a recent press release, pMD®, the innovation leader in health care technology, announced it has been named one of the 2020 Best Small & ... Reducing Length of Stay in Hospitals, Benchmarking GMLOS. Several different classification systems exist with varying levels of grouping precision and levels of specificity. Prioritize Patients to Be Discharged for Labs/Clinical Procedures. M (Measurable) Through statistics to assess the effectiveness of the standard. Visibility tools can allow physicians to identify delays in the system and react accordingly. 1 . 4. See our. Potential Implementation Challenges: Census forecasts will need to be reviewed on a regular basis — perhaps multiple times a day. In some cases, it may be more desirable to move the patient to a local hotel and report back in the morning for an outpatient procedure. The flow of patients from the OR is significant and can cause spikes in the inpatient census but is more controllable than the census contribution from the ED. This can lead to some disruption during the transitional period. Potential Implementation Challenges: This will require a change to the daily schedule for clinical teams. Reducing length of stay can produce direct and meaningful benefits for hospitals, including freed up beds, reduced costs and reduced risk of hospital-acquired infections. Ten Factors Worth Considering: I have identified ten factors that, if addressed precisely and with the right data and predictive analytics, can reduce LOS: Incorrectly assessing the required size of a unit leads to a higher percentage of patients not being placed into their target unit, longer wait times to get patients out of the ED, and more complexity in decision-making. Author information: (1)1Boston University School of Public Health, Boston, MA, USA. LinkedIn recommends the new browser from Microsoft. 8. Potential Implementation Challenges: Most hospitals facilitate some prioritization in the lab queue for urgent cases. Although virtual and not necessarily located in one single unit or floor, this virtual unit can still consist of several sizeable subunits. The objective of this study was to investigate the … To remedy this, hospitals can reduce the size of the specialty units and open a larger (“virtual”) general medicine unit. This was easily possible when performed in group therapy. They begin looking at how length of stay is measured and why it is important. The surgical unit at Mercy Hospital is trying to reduce costs and length of stay for patients. Why are we trying to reduce length of stay? The inpatient census is notoriously volatile in most hospitals. Nurses’ Role In Reducing Length of Stay At The Hospitals: The Basic Nursing Care Edit article. UK health services are under pressure to make cost savings while maintaining quality of care. This can lead to slower recovery times and even clinical complications. Sanjeev graduated Phi Beta Kappa with an EECS degree from MIT and along the way spent time at McKinsey & Co. and Cisco Systems. However, there is often significant variation in length of stay between hospitals, suggesting that improvements could be made. The Reducing Length of Stay (RLoS) programme aims to provide patients with a better care experience by ensuring they are discharged from hospital without unnecessary delay. For example, a patient admitted on Friday afternoon may have a longer stay due to test results not being available since the lab is closed on weekends. Topic Brief: Interventions to Decrease Hospital Length of Stay. Key Benefit: Reducing Patient Length of Stay We can't cure your patients - only your doctors and nurses can do that - but we can fix your processes to ensure timely discharge of patients fit to leave. Available evidence on effective interventions to reduce length of stay in hospital is wide-ranging and complex, with underlying factors including those acting at the health system, organisational and patient levels, and the interface between these. 7. More efficiency, better collaboration. Sanjeev Agrawal is president and chief marketing officer of LeanTaaS iQueue. Solution: Utilize multiple data sources and sophisticated machine learning techniques to provide a more accurate and granular forecast. What is the effectiveness of structured multidisciplinary rounding in acute care units on length of hospital stay and satisfaction of patients and staff? In addition, addressing these issues also typically improves the patient and provider experience; it leads to reduced wait times in the emergency department (ED), fewer issues with boarding, quicker discharge and an overall “saner” experience for everyone involved. As a health care provider, you’ll spend less time wrangling annoying details and more time doing your job. However, there are concerns that excessively reducing length of stay may reduce healthcare quality, such as increasing readmission rates. Reducing Hospital Length of Stay: Topic Nomination from the LHS Panel Project . The hours of operation for certain procedural areas, labs and imaging can impact LOS. Ashby J, Guterman S, Greene T. An analysis of hospital productivity and product change. Solution: Implement a prioritized queue and identify patients that are close to discharge to ensure that discharge delays due to lab tests are minimized. The challenge of reducing length of stay is to do it without reducing quality. Hospitalization often results in a decline in functioning for older adults due to interactions of aging, disease, and hospital factors. Background: A recent study suggested that levofloxacin significantly reduces the hospital length of stay (LOS), by 0.5 days (p = 0.02), relative to moxifloxacin in patients with community-acquired pneumonia (CAP). Reducing Healthcare Costs. Patient room rent, daylight, and views of the outside reduced length of stay (p<0.001, p=0.016, and p=0.037, respectively). Spikes in the census cause huge difficulties in capacity management, staffing and patient placement. Moving a patient close to discharge up in the queue can avoid delays. 5 No. Measures to reduce the length of hospital stay are among the main approaches to enhance a hospital's operational efficiency. The awareness that they had to reduce length of stay, alone made them more critical of whether a patient really had to stay any longer in hospital or could be discharged. Currently at Feel Better Hospital, the Average Length Of Stay (ALOS) for patients under Hospitalist care exceed the benchmarks for large community non-teaching hospitals. Beyond those two factors, though, there are several general operational considerations that have an impact on LOS and are more straightforward to address. Health + Tech | Reducing Hospital Stay With Technology According to a study conducted by the Imperial College London, Imperial College Business School, South Kensington, London, UK, a hospital stay carries a 5.5 per cent risk of an adverse drug reaction, 17.6 per cent risk of infection, and 3.1 per cent risk of ulcer for an average episode. That’s a considerable increase in patient access and millions of dollars in additional income from the same fixed capacity. What Health IT Needs to Look Like in 2019 to…. Accurately predicting patient census can be vital for daily unit management. Objective: The aim of the study was to investigate whether patients who undergo surgery in hospitals experiencing significant length of stay (LOS) reductions over time are exposed to a higher risk of severe adverse events in the postoperative period. Faced with declining revenue related to changes in Medicare and Medicaid reimbursements, Memorial Hospital at Gulfport knew additional methods of providing more efficient and cost-effective quality care were needed to maintain long-term success. where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Care that is focused on particular patient groups or conditions can be helpful in reducing length of stay. Nearly 350,000 patients currently spend over three weeks in acute hospitals each year.