A Rural Hospitals Journey to Improving Length of Stay
Since 2023 United Memorial Medical Center (UMMC) identified the need to improve our acute care length of stay (LOS). In quarter 1 of 2022, our quarterly length of stay was 5.3 days and our goal was 3.51. To tackle this complex challenge we developed a multidisciplinary team inclusive of our hospitalists, chief medical officer, associate chief operating officer, nursing leaders, care management, physical therapy, and quality specialist. Using lean six-sigma methodologies, we identified gaps and implemented several interventions which led to a vast decrease in our length of stay by quarter 4 of 2024 to 3.52.Problem:LOS is often used as a quality measure. Excessively long hospital stays a can signal issues with care delivery and discharge planning. Monitoring and managing hospital length of stay is essential for enhancing patient care, optimizing resource use, controlling costs and improving overall healthcare system efficiency.
Measurement: LOS for hospital admissions are defined by the duration of a single hospitalization, calculated by subtracting day of admission from day of discharge. Financial LOS is the total non-exempt inpatient discharges across medical- surgical and obstetric units. Behavioral health is excluded due to patients requiring longer length of stays.
Analysis: The fishbone diagram methodology is a visualization brainstorming tool to assist in identifying causes of a known issue. It allows the scope of the investigation to be narrow and establishes a shared understanding of possible causes and solutions. Our analysis revealed several opportunities for improvement across the care continuum.
Implementation: Actions were targeted around understanding data, optimizing resources and developing relationships with outside agencies. Interventions were developed to create efficiencies within processes affecting delivery of care and discharge planning. Collaboration with outside agencies is ongoing and a great way to ensure future improvement opportunities are identified and mitigated.
Results/Discussion: In quarter 1 of 2022, our quarterly length of stay was 5.3 days and our goal was 3.51. Using lean six-sigma methodologies, we identified gaps and implemented several interventions which led to a vast decrease in our length of stay by quarter 4 of 2024 to 3.52.
Speakers
Quality Coordinator - Rochester Regional Health
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Performance and Process Improvement
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Location Virtual
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Organizer NAHQ Next
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