Length of stay reduction/management
A group of 12 New Jersey hospitals offered upside incentives to individual physicians based on their performance on various efficiency metrics, leading to significant cost savings without negatively affecting quality of care.
Massachusetts banned ambulance diversions and helped hospitals respond to the ban by improving patient flow, leading to reductions in emergency department length of stay for admitted patients, shorter turnaround times for ambulances, and strong support from emergency department leaders who believe the ban has yielded multiple benefits.
A recuperative care program provides homeless clients with housing, food, medical care, case management, and connections to social services after hospital discharge, resulting in improvements in their medical and housing status, fewer emergency department visits, and meaningful cost savings for participating hospitals.
Partners in an accountable care organization share risk via an annual global budget and implement initiatives to improve efficiency and quality, leading to reductions in hospital use and overall health care costs.
A comprehensive bundle of process improvement strategies improved patient turnaround time in the emergency department, which in turn led to fewer patients leaving before being treated.
As an alternative to inpatient care, an outpatient center located within a hospital with a stroke center evaluates stable patients who have experienced a recent transient ischemic attack, leading to more timely and comprehensive care, and to significant cost savings through the avoidance of unnecessary admissions.
A redesigned inpatient care model based on Toyota Production System principles uses daily multidisciplinary clinical team visits, individualized care plans, and facility and staffing changes to reduce costs and average length of stay and improve adherence to recommended care processes, nurse productivity, and patient, staff, and physician satisfaction.
A hospital partners with a residential alcohol treatment center to offer medically stable emergency department patients with acute alcohol intoxication an alternative treatment setting, leading to lower emergency department length of stay, cost savings of nearly $2,000,000, and anecdotal reports of improved patient outcomes.
Working as part of an “intensive care unit without walls,” critical care physicians (called intensivists) decide which patients require intensive care unit admission and oversee the care of all critically ill patients throughout the hospital, leading to declines in hospital and intensive care unit mortality, improved management of intensive care unit bed capacity, and low intensive care unit length of stay for terminally ill patients.
A Sickle Cell Day Hospital provides an alternative to inpatient care for patients with sickle cell anemia, with the goal of managing their pain and keeping them out of the hospital, resulting in lower inpatient lengths of stay and emergency department utilization.