Length of stay reduction/management
A hospital emergency department triages moderately acute patients to a “midtrack” area where a nurse practitioner further evaluates them and provides treatment under a physician's supervision, leading to lower length of stay and fewer patient walkouts.
A partnership between a health plan and psychiatric hospitals focuses on sharing of quarterly data, case reviews, and deployment of specific strategies to improve postdischarge care, leading to significant reductions in readmissions, inpatient days, and costs.
A rapid admission protocol streamlines the process between the decision to admit an emergency department patient and the arrival of the patient on the inpatient unit by reassigning care responsibilities and reducing process steps, leading to reduced emergency department boarding time.
A Medicare Advantage plan uses employed “extensivists” who perform traditional hospitalist functions for a smaller-than-average caseload of patients, and then continue to follow and care for these patients after discharge until their condition becomes stabilized, leading to low length of stay and fewer readmissions.
A hospital-based telephone triage system allows patients to describe their symptoms to a nurse, who uses an algorithm to assess acuity and determine the best setting for treatment, leading to reductions in emergency department patient volumes, wait times, average length of stay, and walkouts.
In instances of institutional overcrowding, a protocol allows patients admitted to the hospital but boarded in the emergency department to be transferred to beds located in inpatient unit hallways, leading to expedited patient placement in a room, lower length of stay, and higher patient and staff satisfaction.
During peak census hours, phlebotomists are assigned to work in the emergency department to quickly collect blood specimens and label them for priority processing and analysis by laboratory staff, leading to faster turnaround times, lower rates of blood culture contamination, more than $400,000 in annual cost savings, and higher levels of patient satisfaction.
Inpatient capacity management strategies initially developed to accommodate the potential influx of patients during a natural or manmade disaster were adopted for everyday use by a capacity-constrained hospital, leading to earlier-in-the-day discharges, steady length of stay despite rising patient acuity, and a multimillion dollar financial return due to increased throughput, with no negative impact on quality or patient satisfaction.
Clinicians in a tertiary hospital continuously monitor and intervene as necessary with critical care patients in rural facilities via telemedicine, leading to reductions in mortality, length of stay, number of patient transfers, and costs.
A comprehensive program to improve patient experience before, during, and after orthopedic surgery leads to improved satisfaction, higher patient volume, and better patient outcomes.