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American Journal of Medical Quality
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Enhanced Length of Stay Management through Monitoring of Discharge Planning Parameters

Cynthia M. Walsh, R.N., B.S.N.

Carney Hospital, Boston, Massachusetts

John S. Coldiron, M.D., M.P.H.

Carney Hospital, Boston, Massachusetts

Traditional data collection in discharge planning programs has been largely retrospective, measuring the patient's length of stay and unnecessary hospital days at the point of discharge. Although the data collection is useful, it does not lend itself to corrective actions on a concurrent basis. Carney Hospital has developed a data base that monitors patient status daily in order to identify when a length of stay prob lem is developing and when corrective actions are succeeding.

The Patient Tracking System is an interactive com puter report utilized by Continuing Care staff, Utili zation Review staff, and clinical managers on the patient care units. It is a caseload register that oper ates from the admission transfer discharge (A/T/D) system of the hospital and sorts inpatients by dis charge planning status, length of stay, discharge planning worker, and nursing unit. It is the basis for a weekly management review that identifies numbers of patients and average length of stay to date of key groups of patients proven to impact the overall length of stay in the hospital.

Carney Hospital has successfully utilized this sys tem to alert managers to any length of stay "creep," to identify the sources of the length-of-stay problem, and to mobilize key personnel to take corrective ac tions. The system is easy to use and is an effective length-of-stay management tool.

American Journal of Medical Quality, Vol. 8, No. 3, 128-133 (1993)
DOI: 10.1177/0885713X9300800304
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