Shorter stays, better outcomes

By: Mihir Patel, MD | CEO, Hospital Medicine 

Top 3 takeaways to reduce length of stay

Sound Hospital Medicine Chief Executive Officer Dr. Mihir Patel recently joined a roundtable hosted by Becker’s and part of the Becker’s Hospital Review 15th Annual Meeting. This post is a summary of that discussion.  

A patient’s length of stay (LOS) in the hospital impacts so many factors, from reimbursement rates to health outcomes, which is why hospitals and health systems have made it their top priority. So, what’s the best strategy to help reduce length of stay (LOS)? 

There are a few approaches to consider that, when taken together, more meaningfully affect patients’ length of stay.  

Early planning and involvement from all caregivers

Clinical and quality teams—the keepers of patient safety, operational efficiency, and clinical effectiveness—should be thinking about length of stay, every day.  

So, too, should outpatient providers that serve as a patient’s first point of entry into the health system. Family practitioners hold critical knowledge about that patient’s health history to help guide a more successful stay in the hospital. 

Finally, caregivers—often family members—play a critical role in educating the care team, flagging barriers to care once out of the hospital, and providing necessary insights into the bigger picture. 

Leading with, not above: Working together to remove barriers

While hospitalists can identify the barriers to reducing LOS, leaders in the C-suite have the operational power to effectively remove them.  

“Hospitalists require a lot of support from hospital executives,” said Dr. Patel. “Reducing LOS doesn’t work by hospitalists waving and saying, ‘I want to reduce LOS.’” 

When hospital leaders take the time to empower their hospitalists—working in concert with them to better understand the barriers and why they exist—the path to removing those barriers becomes much clearer and more effective. 

Not all LOS is created equal

The trend in recent years has been to move away from looking at overall LOS that includes more complex patients whose LOS tends to be longer and, instead, toward geometric mean LOS, an adjusted metric from the Centers for Medicare and Medicaid Services. Hospitals are also showing willingness to consider the ways average LOS differs across service lines, accounting for different patient types and care complexity. And Sound has found success in shifting away from Monday-through-Friday operations to seven-day-a-week operations with multidisciplinary rounds.  

“On these rounds, you’re talking about patient throughput,” said Dr. Patel. “You’re talking about how we can move patients along in their journey and prepare them for safe discharge while at the same time reducing LOS—so that’s the strategy.” 

To hear more from the panel experts, you can read the full Becker’s piece here.