How to Decrease Length of Stay in Hospitals
Spoiler Alert: It’s About Visibility and Automation
It’s time to get a handle on patient length of stay.
In our last article, we delved into 7 key factors extending patient length of stay at your hospital. What becomes clear when looking at those delays is that even minor process improvements have the potential to dramatically reduce length of stay and, in turn, avoidable days. This can improve revenue, patient outcomes and overall efficiency of your health system.
And that leads right into the topic of this article, the concluding installment in our three-part series on length of stay: how to decrease length of stay in your hospital.
(View Part 1 of the series here and Part 2 here)
1. Automate Your Manual Processes
If fax machines and phones are included within your patient discharge workflow, then eliminating these can provide a significant reduction in length of stay. Doing so will also make the staff members responsible for these tasks more efficient than they’ve ever been.
What you’re looking for is a system that can disperse the patient’s health information from the EHR to all prospective post-acute care (PAC) facilities.
Automation allows your team members to send the post-acute referral inquiry to the selected PAC providers instantly, which can reduce length of stay by hours, if not days, for a high-complexity patient. You don’t have to worry about leaving voicemails, waiting by the phone, or returning calls because it happens in the background of your team’s other duties. And once they receive their post-acute responses, they can immediately accept the placement and finalize the discharge.
Additional tip: You’ll want a system that comes with an electronic faxing option. That’s because, unfortunately, not all PAC facilities are willing to adopt the same software, even if the majority recognize the benefit of being part of such a network.
A solution that provides the ability for those holdout PAC providers to receive and send the patient’s discharge summary via fax is therefore essential. That way, your team doesn’t have to worry about tracking what parties use fax and which don’t, which would add another database and more labor hours.
2. Know Your PAC Options…With a Vetted Database
Knowing what post-acute care facilities are available is a task that’s more complicated than it may seem. Asking your team to keep track of this information isn’t an efficient option.
The answer is tapping into a post-acute network that’s already been vetted for you. When choosing your automation software, one of the key factors to look at is the status of their post-acute network. Any software you choose should track facilities, their care capabilities, contact information, ratings and more. When this information changes, it should be updated and cascade throughout the software’s database.
In this way, your team can be confident their prospective post-acute care providers are up to date and, in the off chance something has changed, the change can populate across your entire health system once corrected so that the issue doesn’t repeat for the next attempted transfer.
3. Remove Discharge from Your Clinicians’ Workload
Once you’ve enacted the two process improvements above, you’ll go a long way toward making your team more efficient. But there’s one other major way to go even further.
If responsibility for discharging the patient falls to a nurse or anyone else on your team who should otherwise be overseeing clinical functions, it’s time to rethink that process. It’s better to have case workers, medical assistants or other support team members oversee discharge, thus freeing your clinical team, including nurses, to conduct more top-of-license work.
If you’re not prepared to hire additional full-time employees to carry this caseload, there’s another option: sourcing the entire patient orchestration process, from intake to discharge, to an organization with expertise in that area. Doing so ensures discharge is as efficient as it can be and lets your team focus exclusively on clinical work rather than administrative tasks.
Think of this as an opportunity to reclaim efficiency at multiple levels within your organization, bringing true systemness to the patient’s journey through your health system.
4. Gain Control of the Transportation Picture
If patients are reliant on your hospital for transportation to the next care setting, then the faster you can connect them with an acceptable transport provider, the faster you can free up your bed for the next individual.
Just as software makes a difference for discharging to PAC providers, so too will such a solution bring automation to the transportation picture at your health system. You’ll want to look into a product that offers a window into all transportation options in your area, including unit availability, capabilities, ETA and more.
When you can schedule pickup and drop-off from one centralized system, you’ll set your patients up with their needed transport provider faster than ever, and delays and heightened costs resulting from inaccessibility will become a thing of the past.
5. Track Post-Acute Bed Availability
Knowing what post-acute beds are available is admittedly difficult, as you’re often reliant on post-acute care facilities to keep close tabs on this information. They don’t always do this or, if they are tracking this information, the details may not always get to you.
But there are steps you can take to alleviate this issue. First, if your health system owns any post-acute facilities, this is a good place to start. Track how many beds are available, including surge units, and then populate a database with this information that your intake supervisors can update as needed.
For those post-acute providers that aren’t under the umbrella of your health system, that’s a little trickier. We encourage the formation of preferred care networks that can become your go-to for discharging patients, with membership contingent on responding within a certain timeframe and keeping bed availability up to date.
Admittedly, this advice is geared more toward larger health systems that can exert some influence on their post-acute partners, but even smaller organizations can partially address the bed availability issue by automating the discharge process as noted above. That way, even when a post-acute facility is full, you’ll at least get their response much sooner.
6. Document Patient Choice Electronically
One recommended way to meet the parameters of the IMPACT Act, and thus document patient choice, is to do so electronically, before any discharge inquiry has taken place.
If you can present your patients with their options from a tablet-based database at the bedside, allowing them to search and browse based only on the facilities that have the clinical capabilities and payer partnerships necessary to accept the patient, you can expedite the process dramatically.
But that’s not the only way to remove pen and paper and gallons of printer ink (literally one of the most expensive liquids on earth) from the equation. An E-Signature application can enable your patient or their qualified family member to sign off on these choices much more efficiently than having them sign a document each time. Again, you’re taking steps out of the process and making your team more efficient than it’s ever been.
7. Streamline Intake Too
Much of what we’ve covered has focused on making the patient discharge process more efficient, but it’s also possible to reduce length of stay by making the intake process more efficient too.
Getting the patient to where they can receive care, right from the start, can save your health system time and money while improving outcomes. You should be tracking resource availability and capacity within your health system at all times. When one department within the hospital, or one entire hospital within a system, is strained, you should have a plan in place for other areas to take on that capacity.
It’s only when you track data from hospital to hospital and clinic to clinic that you can create processes that bring true efficiency. You should be able to determine, for instance, whether your flagship hospital is taking on too many appointments while a facility ten miles away has team members without enough care duties to fill a shift. The idea is to balance patient volume across the system, preventing roadblocks by shifting people and resources precisely where they need to go.
At ABOUT, we call this concept orchestration. It’s something we’re passionate about because we’ve seen the outcomes, both financial and clinical, that result. If you’re ready to reduce length of stay from intake to discharge at your organization, let’s talk about how we can do so together.