Healthcare Mergers, Acquisitions, and Partnerships, https://www.hcup-us.ahrq.gov/reports/statbriefs/sb180-Hospitalizations-United-States-2012.pdf, Allina Health: A Successful Approach to Improving VTE Care and Prevention across a Large Health System, How Allina Health Deployed Evidence-Based Decision Making and Reduced Variation, How Allina Health Improved Spine Care Variation and Outcomes, Achieve Reduced Heart Failure Readmission Rates: One Healthcare Organization’s Care Coordination Strategy, Allina Health and Health Catalyst Sign $100 Million Agreement Creating Model for System-wide Outcomes Improvement, I am a Health Catalyst client who needs an account in HC Community, $13.4 million in direct operating expenses saved, Hospital capacity (bed availability) created for 5,000+ admissions, Avoided adverse patient events and reduced the total cost of care, Meaningful opportunities for improvement could not be identified across the organization, Performance data could not be used to adjust clinical decision making during patient hospitalization, An intuitive computer system that did not require significant technical skills to use, The ability for end users to directly access data and create detailed reports in near real-time. It engaged the hospitalists through frequent reporting of LOS performance data, by provider, in a way that was transparent and non-accusatory. Retrospective database study. Memorial also engages providers in its improvement efforts, sharing provider-specific, individual performance data, including LOS, readmissions, avoidable days, and consult delays with each provider. Addressing complex operational and clinical processes requires a specified group to champion the work, lead interdisciplinary teams, and provide oversight to the LOS initiatives, which did not initially exist. Optimizing LOS was a strategic priority for Allina, but there were two main reasons its analytic and technical capabilities did not previously enable the organization to improve performance and reduce LOS: Allina’s primary challenge was the inability to identify meaningful opportunities for improvement across the organization. Cost: reference to financial cost or economic impact in any care setting. Health Catalyst. Memorial understood the importance of data and analytics in accomplishing its objectives. OBJECTIVE: Economic evaluation has become increasingly important in healthcare and infection control. Each MS-DRG had a national average LOS, known as the geometric mean LOS (GMLOS), and the GMLOS was used as a benchmark for Allina to compare its acuity-adjusted performance externally. Enterprise Data Warehouse / Data Operating System, http://www.hcup-us.ahrq.gov/reports/statbriefs/sb180-Hospitalizations-United-States-2012.pdf, https://www.hhnmag.com/ articles/3378-inpatient-care. Incremental Costs Associated with Length of Hospitalization Due to Viral Pneumonia: Impact of Intensive Care and Economic Implications of Reducing the Length of Stay in the Era of COVID-19 Length of stay (LOS) affects both cost and revenue and often has enormous implications to the institution's financial well-being. Data suggested inconsistent resources and more avoidable hospitals days on the weekends. , Allina has seen dramatic improvements in LOS in its initial years and has maintained performance nationally as other health systems simultaneously work to optimize LOS performance (see Figure 5). With the access to data and the developed infrastructure, LOS optimization has moved into ongoing support stages. May we use cookies to track what you read? Healthcare Mergers, Acquisitions, and Partnerships, How Allina Saved $13 Million By Optimizing LOS, Standardized Best Practices Improve Elective Colon Surgery Outcomes, Evidence-Based Care Standardization Reduces Pneumonia Mortality Rates and LOS, How to Avoid PQRS Penalties and Earn Potential Incentives with Accurate Submission of Quality Measures, Patient-Centered LOS Reduction Initiative Improves Outcomes, Saves Costs, I am a Health Catalyst client who needs an account in HC Community. The Importance of Length of Stay in Hospitals. Often, if patients were not discharged by Friday, they would still be in the hospital the following Monday, as there were few weekend discharges. Advances in Bioscience and Biotechnology, 2014. Data for 751 ICU patients in 1998 at two hospitals used to develop weighted length of stay index. As one of the largest healthcare systems in the Upper Midwest, serving 41 communities with 13 hospitals and 61 clinics, Allina Health knew that if it could reduce length of stay while continuing to deliver high quality care, it could realize significant cost savings. Communication gaps between providers, registered nurses, and case managers led to delays, rework, and frustration. Additionally, the values used to calculate performance to GMLOS are updated annually based off of the updated CMS values released in the fourth quarter of the year. Additionally, these patients represent a significant economic problem on public health systems and their families. It can also improve outcomes by minimizing the risk of hospital-acquired conditions. Memorial engaged the utilization management (UM) committee, which consists of administrators, providers, revenue cycle and performance improvement staff to review LOS and resource utilization, ensuring appropriate care is provided, and patients are progressing toward safe discharge. The surgical unit at Mercy Hospital is trying to reduce costs and length of stay for patients. We take pride in providing you with relevant, useful content. First, providers across the organization supported the data and believed in its accuracy due to the specificity, acuity adjustment, and benchmarking available. Third, Allina created performance reports for individual sites, provider groups and individual providers, clinical service lines, nursing units and ancillary departments, quality departments, and leadership across the organization. . The following approaches were highlighted as having a positive impact on improving flow and length of stay. Hospital inpatient care makes up nearly one-third of all healthcare expenditures in the United States, and represents a significant impact on the country’s economy. Further complicating matters was the need to enhance communication between disciplines, while also improving processes to facilitate discharge planning, for example: Prolonged consult response times also emerged as a key factor for Memorial. Using this method, the finance LOS was calculated and reported in whole days from admission date to discharge date. The ability to segment the population by numerous variables, including method of arrival, discharge destination, clinical service line, discharge unit, ICU utilization, etc. Memorial is one of the most comprehensive healthcare systems in Mississippi and includes a 303-bed acute care hospital handling over 17,000 patient discharges annually. Length of Stay For the NHS, the size of the productivity opportunity in acute hospitals alone has been estimated to be more than £4.5 billion, including savings from reducing length of stay. HC Community is only available to Health Catalyst clients and staff with valid accounts. All rights reserved. Hospitalists have embraced the strategic effort and implemented several changes to further reduce LOS including: In addition to implementing these new processes, members of the case management leadership team review data weekly from the EMR on LOS outliers. Through observation of clinical workflows and discharge processes, Allina identified opportunities including the following: Figure 4: Relationship between Discharge Order and Time of Actual Discharge. Dysphagia: reference to a patient group with impaired oral and/or pharyngeal swallowing (oropharyngeal dysphagia). And their families hospital or Medicare-Severity Diagnosis related groups ( MS-DRGs ) Committee. 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