JHQ 4841: Intervention Bundle to Reduce Hospital Length of Stay in a Quaternary Academic Department of Surgery-JHQ 4841: Intervention Bundle to Reduce Hospital Length of Stay

JHQ 4841: Intervention Bundle to Reduce Hospital Length of Stay

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A quaternary academic surgery department introduced a bundled initiative to reduce hospital length of stay (LOS) and improve patient flow. The bundle combined daily multidisciplinary discharge rounds, quarterly surgeon- and procedure-specific LOS performance reports, and updated electronic health record templates that better documented patient complexity for risk adjustment. Standardized, multilingual discharge instructions were also introduced to support safe discharge and help prevent readmissions.<br /><br />The team prospectively tracked monthly Vizient LOS measures from June 2022 to June 2025, comparing pre- and postintervention results. Among analyzed patients, average observed LOS fell from 6.21 to 5.78 days—a reduction of 0.43 days. The LOS index, the ratio of observed to expected LOS, improved from 0.950 to 0.857. Both changes were statistically significant. The 30-day readmission rate remained stable, declining slightly from 10.7% to 10.4%. The reduced LOS was associated with estimated annual savings of $5.1 million.<br /><br />The authors conclude that coordinated operational changes—discharge planning, transparent performance feedback, and improved documentation—can improve throughput and resource use across surgical services. However, because interventions were introduced as a bundle, the study cannot determine the separate effect of each component. Changes in coding practices, wider institutional initiatives, and other factors may also have contributed to the results.

Keywords

quaternary academic surgery

length of stay reduction

patient flow

multidisciplinary discharge rounds

LOS performance reports

electronic health record templates

risk adjustment

discharge instructions

readmission rate

throughput optimization