How To's

How to Reduce Length of Stay through Communication Performance Metrics

June 19, 2017 | Uniphy Health

by Dr. Stuart Hochron, MD, JD

Why Length-of-Stay Is Important to Hospital Managers

A hospital’s ability to control length-of-stay (LOS) is directly related to patient satisfaction and profitability…two reasons why healthcare system CEOs include LOS reduction among their top priorities. Observation LOS, because of its short-term impact on patient throughput and patient satisfaction, has become an often-used reflection of overall management effectiveness.

Requirements for Success

LOS managers identify communications delays as a key factor that contributes to longer-than-necessary hospital stays. Until recently, however, objective communication performance metrics have not been available. This case describes how managers use Uniphy Health’s communication performance product to measure performance and adjust communication policies and procedures to improve outcomes. The results were reported by the hospital’s EHR during the first 45 days after deployment.

Communication Barriers that Increase LOS

Communication workflow barriers take many forms that include:

  • Communications among and between treating physicians and nurses
  • Transmission of clinical information from reporting systems to decision makers
  • Communications between case managers and other care team members
  • Reporting of diagnostic study results from interpreting physician to decision makers
  • Requests from case managers to home transport services
  • Communication of policies and procedures from managers to staff
  • Sharing of team and individual communications performance metrics

 How It Works

Managers are able to reduce length of stay by collecting, identifying, responding to and tracking communication delays in areas where inefficiencies contribute to a higher LOS.

A 325-bed hospital employed a mixed model to manage observation patients which included ED and specialty physicians, rotating nurse practitioners, nurses, sub-specialty cardiologists, radiologists, post-acute care physicians, case managers, transport dispatchers and other personnel. The hospital used Uniphy Health’s products to:

  • Map observation communication workflows
  • Identify communication workflow delays
  • Connect all physicians, nurses and support staff within and outside the acute-care setting using a single communications platform
  • Automate the delivery of critical labs, consultation requests and radiology reports from the EHR to the appropriate ordering or responding physician(s) and NPs
  • Monitor roles-based communication flow among and between categories of personnel
  • Collect, respond to and track key communication performance analytics including care team and individual:
    • Volume & types of communications
    • Flow among and between care team member categories and roles
    • Response times

Results

With the aid of communications performance metrics based on individual and team member roles, managers were able to consistently reduce average observation time. Within 6 weeks, average observation time was reduced by 11% to a level that had not been achievable, despite considerable effort, over the previous two years.

  • Managers described Uniphy Health’s communications performance analytics in the following ways:
    1. “The type of data analytics we need to manage teams”
    2. “Provides me with never-before available information that I use to improve care team efficiency”
    3. “Differentiating with regard to my ability to deliver efficiency”, and
    4. “Very valuable”
  • Communication volume doubled nearly every week during the first six weeks
  • Performance metrics improved weekly
  • 11% lower average observation time 45 days post-deployment
  • 14% lower average observation time among care teams using the product