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Care progression huddles improve length of stay

23 Apr 2023

LOS strategy update

By: Dr. Kathleen Harder, Associate Chief Medical Officer and adult hospitalist, Salem Health Medical Group

Reducing length of stay for patients improves financial, operational and clinical outcomes. Nationally, length of stay has increased substantially — by nearly 20% from 2019 to 2022.

Salem Health is no exception to that trend. To address this problem, over the past 10 months the Length of Stay (LOS) Strategy Deployment Team worked with SHMG adult hospitalist providers, nursing leaders and other leaders to understand the complex issues that drive prolonged stays. Detailed analysis and collaborative problem-solving helped us identify metrics, but there is more work to do. We are currently still half a day off from the fiscal year target for this strategy work.

In February we launched a daily care progression huddle in which the attending provider, LOS navigator, bedside RN, care management and physical therapy staff discussed the patient’s estimated discharge date and the clinical goals to progress their care. Not only has this process shown improved LOS metrics, it has also increased collaboration and understanding among all care team members. This test of change is currently live in three units, and will spread housewide very soon.

As this important work continues, it is clear that collaboration with all our partners, including our subspecialists and acute care consultants from the community, will be imperative to achieve our triple aims of adequate hospital capacity, patient safety and organizational financial health.

Appropriate inpatient versus outpatient resource utilization will be identified, and barriers to patient throughput will be discussed with our subspecialist and consultant partners. We’ll have more information on how you can help in the work in the coming weeks. We look forward to working on this project with you!