Related Experiment Video
Updated: Oct 20, 2025
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Improving length of stay on a trauma service
Walter L Biffl1, Ning Lu1, Peter R Schultz1
1Trauma, Scripps Memorial Hospital La Jolla, La Jolla, California, USA.
Background:
Reducing length of stay (LOS) is a major healthcare initiative. While LOS is closely linked to the diagnosis and procedure in elective surgery, many additional factors influence LOS on a trauma service. We hypothesized that more standardized patient management would lead to decreased LOS.
Methods:
Retrospective analysis of Trauma Registry data compared LOS before (PRE) and after (POST) implementation of standardized processes on a trauma service. Patients were subdivided by age (over and under 65 years). Data were compared using unpaired t-test, χ2 test and analysis of variance tests, where appropriate.
Results:
1613 PRE and 1590 POST patients were compared. Although age and Injury Severity Score were similar, median LOS decreased by 1 day for the group overall (p<0.0001), and for subgroups over and under the age of 65 years (p<0.0001). Older patients were discharged home 13% more often in POST, compared with 4% more for younger patients.
Conclusions:
Improved standardization of processes on a trauma service reduced LOS in patients of all ages. A prospective study may identify specific factors associated with prolonged LOS, to allow further improvement.
Level Of Evidence:
III.
Study Type:
Therapeutic/Care management.
Related Concept Videos
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:19Restorative Care
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:21Planning Nursing Care I