Vanderbilt University Hospital in Nashville, Tenn., has achieved a sustained reduction in patient length of stay over the past few years, hospital President Lee Ann Liska told Becker's.
With meaningful change in this metric over the past two years, the mean length of stay year-to-date in 2024 is 5.86 days, compared to 6.08 days in 2023. This reduction applies to more than 16,000 discharges, Ms. Liska said.
"In addition, we've also done 1,400 more discharges this year than prior, and some of that increase, though not all, is explained by improved patient care efficiency," Ms. Liska said.
Ms. Liska attributed the success to executive physician leadership and bedside care provider engagement.
"We also highlight a service area and their performance with length of stay every week in our senior leadership pillar huddles, and it helps keep everyone focused," she said.
Accurate documentation of patient acuity and comorbidities is another key factor driving these results, Ms. Liska noted.
Vanderbilt University Hospital set its goals using pre-COVID-19 performance levels from 2019, accounting for the pandemic's effect on length of stay management. Goals are further adjusted based on case max index to reflect the hospital's patient acuity, she said.
"We are always at or over capacity in the hospital, as many hospitals are," Ms. Liska said. "So that constant pressure to place patients who might be waiting in the ED or patients who may be waiting at an outlying hospital for one of our beds keeps us very focused on length of stay."
Ms. Liska said challenges such as delays in post-acute placement — to rehabilitation hospitals or skilled nursing — also affect length of stay. Socioeconomic determinants of health can exacerbate these delays, particularly for trauma victims from out of the state or country.
Chief of Staff Warren Sandberg, MD, PhD, has partnered with Ms. Liska in the hospital's efforts to improve this metric.
"Having your chief of staff very focused on length of stay helps engage the physicians at the highest level, which is really appreciated," she said. "It can't just be administratively led. You have to have a great physician partner to help you with that. But we’re really just the spokespeople celebrating the collective effort of all of the care team members at the bedside. We’re grateful for their efforts and success on behalf of VUMC’s patients."