Length of Stay: An Increasingly Obsolete Metric?

Length of stay (LOS) is the duration of an inpatient episode of care, calculated from day of admission to day of discharge, and based on the number of nights spent in hospital. By tracking LOS, hospitals seek to improve processes and prevent errors, which ultimately lowers costs.

Jessica Farrar, director of strategic planning and decision support, Anne Arundel Medical Center

But for Anne Arundel Medical Center, a 350-bed hospital in Annapolis, Maryland, the LOS metric didn’t sufficiently capture the time a patient spent within the hospital walls.

“We found that [length of stay] is really clunky, in that it doesn’t allow us to look at detailed elements of a patient stay — places where there might be inefficiencies,” says Jessica Farrar, director of strategic planning and decision support at Anne Arundel Medical Center. Her team found that LOS misses fine details like performance differences between units and issues with discharge planning. It also misses a portion of the patient population that doesn’t fall under traditional metrics.

“[Length of stay] only counts inpatient, and hospitals now have patients in non-inpatient status who are in a room. We have patients who are observation status or patients who are technically outpatients that are postsurgical who recover in a room on a floor,” Farrar explains. “So we came up with a metric to really follow the patient — their physical presence as they moved through the hospital environment regardless of their status.”

The program, called “Average Unit Stay,” follows a patient through his or her stay, taking note of the time the patient stays in each unit — not just the time spent from admission to discharge. Implemented in the summer of 2018, this program allows hospital staff to see location and care gaps in real time.

Learn more: Is Length of Stay Still a Valid Measure in a Value-Based World?

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