As a result of initiatives launched in the summer of 2003, length of stay in the Renal Division has been reduced to an impressive 5.1 days. This was a positive result from a plan to combat a 36 percent increase in renal admissions that was unfortunately accompanied by a 20 percent increase in length of stay. Improvements were necessary.
“Our staff worked with administration and other leaders in and outside the institution to bring about a significant reduction in our patients’ length of stay,” said Ajay Singh, MD, clinical director, Renal Division.
The Division concentrated in the following tactics to reduce LOS:
1. Improved communication with Faulkner Hospital’s Emergency Department ensured the appropriate patient cases were handled at Faulkner instead of BWH and vice versa.
2. Headway with BWH’s new Care Coordination Model. The largest feat that resulted was identifying early on those patients who were uninsured, who’d have a more difficult time finding a dialysis outpatient facility to meet their needs. This generated a multidisciplinary approach early on in the patient case. Donna Watson in Care Coordination was highly instrumental in this accomplishment.
3. A strengthened relationship with the Admissions team at Spaulding Rehab better ensured transfers to occur early on in the day, without unnecessary delays. Strides were also made to facilitate a smoother transfer.
4. Increased communication with Interventional Radiology and Surgery Departments to more quickly identify and anticipate problems associated with various patient cases and to attain prompt knowledge of accurate wait times for procedures.
5. Regular meetings with the Renal faculty ensured all staff were moving in the right direction to enable a continued reduction in LOS.
“We were able to shave time off our length of stay without cutting corners. Rather, our plan emphasized increased efficiency and a decreased amount of waste in both time and resources,” added Singh.