Intervention Bundle to Reduce Hospital Length of Stay in a Quaternary Academic Department of Surgery

Length of stay (LOS) is a process metric for optimizing hospital resource planning.

To identify an intervention bundle that would reduce Vizient LOS index for a quaternary, academic medical center department of surgery.

We applied three interventions: (1) multidisciplinary discharge rounds; (2) quarterly data sharing of surgeon- and procedure-specific LOS data; (3) electronic health record (EHR)-based summary capable of capturing patient complexity. We performed a running prospective analysis of Vizient LOS index, assessing impact of interventions implemented in a pragmatic, bundled fashion. Pre- and postintervention LOS data were analyzed using a two-sample t-test to assess statistical significance at a 95% confidence interval for difference in means.

From 6/2022 to 6/2025, 14,754 patients were discharged from the Department of Surgery. When comparing pre- and postintervention data, our bundled efforts led to a decline in observed average LOS (aLOS) from 6.208 to 5.777 days (difference = -0.431; [0.153, 0.709]; t[34] = 3.150, p = .003). This reduction contributed to an improvement in the LOS index (ratio of observed to expected LOS), from 0.950 to 0.857 days (difference = 0.093; [0.053, 0.134]; t[34] = 4.718, p = .000). This reduction in observed aLOS by 0.43 days resulted in an annual estimated cost savings of >$5.1 million.

Implementing bundled LOS interventions helped our quaternary, academic department of surgery reduce LOS and improve throughput while reducing cost.