Length of Stay Improvements Seen in FY04
As a result of an institutional priority to lower length of stay (LOS) in all
inpatient areas, the FY04 average LOS was 5.35 days, representing a 1.1 percent
reduction from FY03. Furthermore, LOS for med/surg patients decreased 2 percent
to 5.55 days. This reduction and ongoing LOS efforts are part of a multi-year
plan that began in FY02.
FY04 began with a 5.61 LOS in October 2003 and concluded with a 5.37 LOS in
September 2004. Throughout FY04, there were only four months in which
the LOS was higher than the previous year's average. The remaining eight months
showed a decline in LOS, with January 2004 having the shortest LOS at 5.07 days.
“These results are promising, especially given an elevated med/surg case
mix index of 2.94,” said Chief Medical Officer Andy Whittemore, MD, who
has been conducting regular meetings with department chairs, division chiefs and
Patient Care Services leadership on LOS strategy. “The hard work of the
many division chiefs and their colleagues has paid off, as the discharge process
is increasingly more efficient and inpatient beds are being made available earlier
in the day.”
Gastroenterology ended FY04 with a 14.5 percent decrease in LOS overall, representing
the service line with the greatest variance from FY03. Vascular Surgery displayed
the second highest variance with an 11.7 percent decrease, and better LOS performance
for 11 of the 12 months of FY04. Neurology also experienced a marked 0.6 day drop,
or 10 percent decrease.
According to Whittemore, in addition to BWH's relatively new Care Coordination
Model, which minimized delays in getting patients access to appropriate alternative
care services, the hospital's progress with intensive data analysis and reporting,
heightened support from physicians and nurses, a revitalized clinical pathway
program, and many hospital-wide clinical management initiatives has made this
LOS reduction possible.
The LOS goal for FY05 is to maintain FY04 performance, despite an anticipated
continued increase in case mix index and patient severity of illness. “Of
course there will be factors beyond our control that could increase length of
stay; however, our current course of action and other improvements for the remainder
of FY05 should help us realize even more reductions,” said Whittemore.