Reducing Length of Stay (LOS) to Meet Geometric Mean Length of Stay (GMLOS) Targets

The goal of this quality improvement project was to reduce the length of hospitalization, to improve patient satisfaction and meet the geometric mean length of stay (GMLOS). At baseline, only 61 percent of patients met GMLOS. The project goal was to track and monitor current length of stay (LOS) and to increase the percentage of patients meeting GMLOS by 10 percent on or before November 16, 2014.

The change/implementation strategy included using the DMAIC (define, measure, analyze, improve, control) DMAIC process and Lean Six Sigma tools. Improvements implemented included educating hospitalists on LOS and benchmarks, entering discharge orders by noon each day, having daily huddles with hospital case management and medical group hospitalists, and working with the new hospital case management supervisor.

Initial results included an increase in the percentage of patients who met GMLOS, from 61 percent (n=28-days' worth of patients) to 71 percent (n=28-days' worth of patients), and an increase in the percentage of discharge notes entered before noon, from 45 percent (n=28-days' worth of discharge notes) to 60 percent (n=28-days worth of discharge notes).

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/