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Getting Patients Home, Faster

Created Mar 01 2018, 08:05 AM by Lippincott Solutions
  • hospital-acquired conditions
  • discharge planning

At an average $1,798-$2,346 per day, the cost of a hospital stay adds up quickly.

Lengthy hospitalizations also increase the risk of pressure ulcers, infections, falls, and other health care-acquired conditions that raise financial consequences even higher.

Plus, there’s this simple truth: most patients would much rather recover in the comfort of their home rather than in the hospital. For these reasons and more, hospitals across the country are focusing attention on how to decrease patient length of stay (LOS).


By trimming LOS by mere hours, hospitals can realize huge financial gains, according to health care innovator Sanjeev Agrawal.

“[If] a 300-bed hospital with an average LOS of four days was able to reduce the average LOS by five percent (i.e., by five hours), they could treat over 1,350 more patients each year. That’s a considerable increase in patient access and millions of dollars in additional income from the same fixed capacity,” he explained in a LinkedIn article.

“In addition, addressing these issues also typically improves the patient and provider experience; it leads to reduced wait times in the emergency department, fewer issues with boarding, quicker discharge and an overall ‘saner’ experience for everyone involved.”


Agrawal, president and CEO of LeanTaaS, provided a handful of practical suggestions on how hospitals can reduce LOS for their patients. Here are a few ideas from his piece:

  • Improve problematic (weekend) hours. Agrawal suggests hospitals take a look at how many patients had no choice but to remain hospitalized over a weekend because the lab, imaging center, or other procedural department was closed. If the percentage is significant, adding Saturday morning hours could keep care moving, test results flowing, and patients moving safely out the door — faster.
  • Prioritize discharges. Patients on the verge of discharge could garner priority status for in-hospital procedures, services, and transport, according to Agrawal. By bumping these patients closer to the front of the line (after patients whose needs are clinically urgent, of course), the discharge process will move smoother and more efficiently and remedy frustrating delays when patients are *thisclose* to going home.
  • Consider outpatient procedures. If it means a speedier exit (and a longed-for return to home sweet home), local patients may be willing to return for necessary services on an outpatient basis, Agrawal asserts. Plus, transitioning to outpatient procedures opens a hospital bed for a patient who truly needs inpatient care. 


At Johns Hopkins All Children’s Hospital in Baltimore, average LOS dropped nearly a third after staff got serious about prioritizing discharge.

Specifically, the hospital expanded its rounding and discharge hours.

“We will discharge a child at 1 a.m. if that child is ready to go home, and this can make a real difference in terms of cost and convenience for families — it may mean one fewer day of work missed for a parent,” pediatrician Akshata Hopkins, MD, said in a Johns Hopkins Medicine article.

The time between discharge order entry and actual discharge also decreased 30 percent.

“Expanding discharge hours and other initiatives have increased access and throughput, and I’m looking now at the impact on the bottom line,” Dr. Hopkins said. “But the real value is how much our patients and families appreciate getting home as early as they safely can.

“It’s just the right thing for the patient.”

Does your organization have any innovative methods for shortening length of stay?  If so, leave us a comment below.