A Win-Win: Managing Length of Stay and Addressing Throughput Challenges
A healthcare system in Southern California with three hospitals was experiencing an increase in volumes. As the only game in town, the hospitals’ volumes were approaching capacity; therefore, resulting in throughput and length-of-stay (LOS) issues, case management roadblocks, patient
placement inefficiencies, and care variation challenges. The system was committed to providing the healthcare their communities needed, close to home. To stay committed to this goal, Quorum Health Resources (QHR) was engaged to drive improvements and focus on evidence-based care.
Strategies and plans were developed to answer this key question: “How are we helping
patients progress toward discharge?”
- Implementing patient-focused care rounds: QHR’s team works onsite with the hospital, facilitating meetings with nurses, physicians, case management and ancillary to create a “plan for the day and plan for the stay” for each patient.
- Improving discharge: By retooling case management processes and roles, the system can provide patients and their families with a proactive discharge plan that effectively meets their needs for a safe discharge.
- Improving patient placement: Maintaining effective structure and process to provide the right level of care, in the right place, at the right time helps the care team maximize skill sets and resources to meet patient needs.
- Reducing care variation: The second half of the engagement will include one-on-one time with physicians to influence physician practice patterns while focusing on evidence-based care.
Reducing care variation will help improve patient care, maintain high quality care and; ultimately, lead the health system to manage costs. QHR continues to guide the hospital’s executive steering committee for this work, assesses scorecards, and provides recommendations and implementation support to help the health system achieve these improvements. At the end of the engagement, the system will be empowered to maintain improvements as well as tackle similar initiatives in the future.
The system is approximately six months into the year-long engagement and is already experiencing a reduction in LOS by .4 days. Additionally, the system anticipates $20+ million in total financial improvement if all recommendations are implemented.
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“This project is a top-priority for us and we are deeply committed to sustaining the success after the engagement ends. It is hard work, but well-organized and well led by QHR’s team. In just six months’ time—we are already experiencing positive results. We are excited to see what the rest of the engagement will bring—particularly in regards to the reducing care variation portion, which we have not yet begun work on.”
- Chief Nursing Officer