Background: Hospital length of stay (LOS) is an important metric for evaluating a healthcare system’s quality of patient care, patient experience and outcomes, efficiency of practice, and resource management. The COVID-19 pandemic led to a significant increase in the average hospital LOS in the United States. Hospital LOS has continued to remain high due to shortages of healthcare workers, discharge delays, and lack of resources during the pandemic. Consequently, there is an increased importance for research and initiatives that can decrease LOS to improve the quality of medical care. The TeamHealth Hospital Medicine Length of Stay program was established to decrease LOS by creating a standardized accessible approach to improve patient care. The purpose of this study is to evaluate the effectiveness of the TeamHealth Hospital Medicine LOS strategies and understand their impact on LOS and the quality of patient care.
Methods: The study spanned 24 months (11-01-2021 to 10-31-2023) with a 12-month pre-interventional (11-01-2021 to 10-31-2022) and 12-month post-interventional period (11-01-2022 to 10-31-2023) encompassing four facilities across the Southeast and Northeast United States. The primary outcome measured was inpatient actual length of stay. Mortality rates, 30-day all-cause readmissions, discharge orders prior to 11:00 AM, and patient experience scores were also measured to assess the quality of care. Demographic data such as average daily encounters, case mix index, and clinician productivity for each facility were collected to account for potential confounding variables.
Results: Results show a statistically significant decrease in length of stay in the post-implementation period compared to the pre-implementation period with no statistically significant difference in quality measures such as 30-day all-cause readmission rates, discharge orders prior to 11:00 AM, and patient experience scores between the two periods. Patient volume showed no statistically significant difference in the post and pre-implementation periods while there was a statistically significant increase in patient case mix index and clinician productivity.
Conclusions: In conclusion, the application of the TeamHealth Hospital Medicine LOS program demonstrated a significant decrease in the inpatient hospital LOS while maintaining quality of patient care. These results provide valuable insights into the ongoing efforts to enhance patient care and optimize hospital efficiency.
