Organisational Interventions to Reduce Length of Stay in Hospital
A Rapid Evidence Assessment
Published in: Health Services and Delivery Research, v. 2, Dec. 2014, 204 p
by Celine Miani, Sarah Ball, Emma Pitchforth, Josephine Exley, Sarah King, Martin Roland, Jonathan Fuld, Ellen Nolte
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| figure 4. Alternatives Evaluated |
Plain English summary
Interventions that lead to a reduction in the length of
time patients have to stay in hospital are widely considered as
effective measures to increase the efficiency of hospitals and,
potentially, reduce costs. However, a large number of interventions
could contribute to achieving this goal, ranging from planned shorter
stays, such as day surgery, to those involving complex organisational
changes, such as stroke units.
In this study we sought to better understand the
evidence base on whether or not, and how well, different types of
organisational interventions in acute hospitals contribute to reducing
length of stay, and other impacts these might have, for example on
patient health status and experience, or on costs. We conducted a review
of the literature published between 2003 and 2013, and carried out
interviews with a small set of NHS managers to help place the findings
of the evidence review in the current NHS context.
Our findings showed that several interventions could
potentially help to reduce length of stay. These included
- multidisciplinary team care, which brings together different types of professionals to deliver, for example, stroke care or rehabilitation;
- improved processes facilitating early discharge from hospital through, for example, better communication between specialists in hospital, general practitioners and community services; and
- clinical care pathways, which describe, for example, the key elements of care and how these should be co-ordinated.
We also found that several interventions
contributed to improvements in patient outcomes, such as reducing
mortality and complications rates, and organisational processes, such as
better collaboration between teams, although they might not have
resulted in reduced length of stay.
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