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, QHR Health 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 worked 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 now provides 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 helped the care team maximize skill sets and resources to meet patient needs.

QHR guided the hospital’s executive steering committee for this work, assessing scorecards, and providing recommendations and implementation support to help the health system achieve these improvements. At the end of the engagement, the system was empowered to maintain improvements as well as tackle similar initiatives in the future.


During the year-long engagement, the system reached its LOS goals for the campuses, representing a reduction in LOS by .54 days in the larger campus and 0.74 days in the smaller campus. Additionally, patients being placed in the appropriate level of care improved by 40 percent. Through this project, the system has achieved $27 million in annualized total financial improvement.

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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 the work is 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

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