Teamwork: Reduced Medicare FFS LOS by 0.88 day in one month

Teamwork goes a long way. I am very proud of the hospital in Southern CA  for the teamwork shown to reduce Medicare FFS length of stay (LOS) by 0.88 days in one month. We started Interim Work in last week of October 2018. Hospital had not much success to reduce LOS in this area for many months. Some thoughts LOS was going higher because the hospital got Stroke Certification and added a new line of service along with growing pains. An initiative was started to admit cases from ED before midnight and it was believed to add some days to inpatient LOS and adding to the LOS. The factors  perceived by the hospitals are real and could be contributing to the increased LOS. The collaborative work between nursing and CM made a positive difference in 30 days. It is not a trend but a good start.


Medicare FFS LOS 2018 Trends



These are preliminary data through the end of November 2018.   Average Medicare FFS LOS has dropped from 5.13 days in Oct 2018 to 4.25 days in the month of November. The gap between the GM LOS or the expected LOS to the Average Medicare FFS LOS is one of the lowest in recent months. It does help when we can manage the LOS to 4.25 days compared to when it took about 5 days to discharge our Medicare FFS cases.
I am proud of the CM  team,  nursing, physicians, CDI team  and other disciplines who help us to manager our cases in the hospital so we can safely discharge them in timely manner. We are closer to the GM LOS (benchmark). If we continue at this pace, it would not surprise me if we will have the Medicare LOS merge or go below the expected LOS in a short few months.
When the LOS drops implies higher efficiency in the operation.
Medicare FFS decreased from 5.13 days in October 2018 to 4.25 days in November, it is drop of 0.88 days per Medicare case  We discharged 266 Medicare FFS cases in the month of November 2018 while recognizing that we had a drop in acuity of illness (CMI) At a very high level, our hospital saved (or got more efficient by) 235 days in the month of November 2018 when we compare this to October 2018 LOS data.
235 days may not look at a big thing.  It means we as an organization had to take care of on an average 7.8 fewer patients per day. This is huge. 
With efficient operation and timely turnaround,  it leaves a few empty beds open where patients in ED do not have wait for inpatients to be discharged. This helps to improve throughput.

If you need consultation to manage LOS and improve patient throughput please refer to a few of the articles written to help in this area using this website. We have posted a few articles on You are welcome to contact us for further consultation to see how we can add value to your organization.