Is Length of Stay Still a Valid Measure in a Value-Based World?
// By Althea Fung //
At the 2018 SHSMD Connections conference in Seattle, SHSMD convened a series of presentations on value as part of its “Value Initiative.” What does value mean for health care organizations? How can they achieve it?
One of the presenters, Jessica Farrar, director of strategic planning and decision support at Anne Arundel Medical Center in Maryland, spoke about traditional metrics that don’t tell the whole story in a value scenario. Length of stay (LOS) has long been a mainstay in quality and efficiency measures, but does it leave out crucial information? What could you use instead?
In today’s value-based care environment, hospitals are under increased pressure to maintain quality while also lowering costs. 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.
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.
Jessica Farrar, director of strategic planning and decision support, Anne Arundel Medical Center
“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 the wide view LOS takes 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.