As health care systems evolve and Length of Stay remains a metric for ongoing monitoring, the following practices contribute to the appropriate use and reduction in Length of Stay:
- Case and care management integrated into patient-centered care models.
- Real-time decision tools based on clinical performance, risk assessments and proactive case management.
- Highly effective, inter-disciplinary teams.
- Predictive modeling and population health management via high risk screening.
- Tracking systems leveraging KPI’s for appropriate patient transition, including a patient-centered care and proactive discharge plan.
- Patient flow analysis for real-time identification of the patient’s current status and services, leveraging clinical analytics and patient data.
- Proactive advancement of each patient through their plan of care.
Data analysis creates necessary, useful information, all while honing in on process. Streamlining services maximizes reimbursement and aids in the patient’s highest health outcomes and transition back into the community. This picture not only produces a better financial gain from services rendered, and reduction of Length of Stay, but it also provides a consumer model for quality and accountable care.
Where the Rubber Hits the Road
Discover where your organization ranks in length of stay by exploring and answering the following questions:
- Is there collaborative engagement throughout your inter-disciplinary team? (i.e. staff, nutritionist, nursing, case management, hospitalist, etc.)
- Is the entire team working toward the common goal of safe, efficient discharge and returning the patient home?
- Is there a plan of care discussed at day one and monitored daily that includes downstream providers?
- Do you have an effective system in place to identify and monitor patients with behavioral issues or special placement needs?
- Are patients kept in the hospital for diagnostics?
- What are some of the delays that detain discharge?
- What is your volume of one and two day stays?
Consider each unit in your organization. Is Length of Stay in critical care extended beyond DRGs and expected best practice?
- Is your organization working collaboratively with post-acute providers both community based and within your health system?
- Is there appropriate discharge case management built into the care continuum to decrease hospital readmission?
De-emphasis on Length of Stay may be of consideration when focusing on cost effectiveness. However, length of stay is the first step in process management, and if your patient-centered process is good, your patients will experience quality care.
Laurie Jaccard is the Founder and President with Clinical Intelligence, LLC