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HBOK 1-102

Title Reduction in Length of Stay for Heart Failure & Shock Patients Admitted To A Medium-Sized Hospital
Author(s) Joe DeFeo and J. Er Ralston
Source ASQ
Topic Performance Measurement

Data Analysis

Performance Improvement

Abstract A medium-sized acute care hospital sought to decrease the amount of time that DRG 127 patients (heart failure and shock) spent in care. The hospital’s average length of stay (ALOS) was 5.18 days, 1.08 days longer than the geometric mean length of stay, 4.1 days. The improvement team identified seven root causes as the vital few driving the extended stay time: congestive heart failure (CHF) standard orders not used, delay between discharge order to time patient leaves floor, patient stay included a weekend, patient becomes deconditioned because of lack of activity, practices were not based on Gold Standards, patients held after meeting InterQual discharge criteria, and inpatient holding process was not being standardized. The pilot project defined solutions for each root cause, successfully reducing the average length of stay at the hospital by nearly 50 percent, from 5.18 days on average to just 2.6. The baseline of stay continues to remain at an average of 3.6 days, well below the Centers of Medicare & Medicaid geometric mean average of 4.1 days.
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Reference Code 1-102

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