Process Improvement Initiative to Reduce Average Length of Stay in a Community Hospital - A Preliminary Report

Average length of stay (ALOS) has increased in many US hospitals in the post-COVID-19-pandemic world. We undertook a process improvement initiative to reduce the ALOS in our community hospital.

Three core tactics were developed with a goal of reducing our ALOS by 10%. These tactics were early mobilization, Interprofessional Partnership to Advance Care and Education rounding, and structured interdisciplinary care rounds. Workgroups in each of these domains designed the improvement, devised measures of success, and implemented the tactic. A process improvement specialist worked with each workgroup using elements of the Model for Improvement. Process measures were reported weekly. Outcome measures (ALOS, observed vs expected LOS) were reported weekly. A central steering committee oversaw the initiative. All tactics were fully implemented by February 2023.

For the first 6 months after implementing our tactics, the ALOS on our inpatient medical units decreased from 6.3 to 5.5 days (13.7%) when compared with the same 6-month period in the prior year (P < .01).

We used 3 interventions to impact the ALOS in our community hospital. Preliminary data show a significant improvement. We cannot isolate the independent contribution of each intervention and did not control for confounders.

Our interdisciplinary team developed and implemented tactics to reduce the ALOS in our community hospital by 13.7%.