A Length-of-Stay Reduction Initiative to Enhance Hospital Efficiency

Document Type

Article

Publication Date

11-2025

Publication Title

NEJM Catalyst

Abstract

Length of stay (LOS) has increasingly been a focus of hospital operations as health systems try to allocate limited resources and contain costs, especially those in value-based arrangements. This article describes the design and implementation of a LOS reduction initiative at two large urban hospitals. Detailed below is the infrastructure created to support process improvement related to LOS across a variety of service lines, including hospital medicine, care management, laboratory, and patient logistics. A variety of the resulting programs and their outcomes are described, as well as contributing factors to their successes and challenges. Key metrics explored include LOS; turnaround times for laboratory orders, thoracentesis, and paracentesis; ratio of patients geographically cohorted; utilization of clinical pathways; and volume of discharge delays. The authors address investment in culture, process establishment and maintenance, fostering interdisciplinary collaboration, and timely and accurate data analytics, as well as their role in optimizing LOS.

Volume

6

Issue

12

DOI

10.1056/CAT.24.0523

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