If you work for a hospital, or a health system with multiple hospitals, it’s highly likely that at some point you’ll hear: "we need to reduce our average LOS!”
Those new to working in healthcare will probably wonder what in the heck LOS means. The acronym stands for length of stay. Basically, it’s how long the average patient at a given hospital occupies an inpatient bed.
In the simplest possible terms, shorter lengths of stay are better than longer lengths of stay, but there is much more to the LOS story.
🤔 Why am I writing about this?
Great question! I know this sounds like a particularly wonky topic for me. However, quite often I see social media comments that make some form of this argument:
“Of course hospitals want to keep patients in the hospital as long as possible. It’s how they make their money.”
It sounds like that theory should make sense, but in fact, the opposite is true.
Ways to reduce LOS are constantly being reviewed by hospitals. Why?
Here is what Google AI has to say:
Reducing LOS significantly improves their operational efficiency, reduces costs by minimizing resource utilization, allows for more patients to be treated with available beds, and generally leads to better patient outcomes by decreasing the risk of hospital-acquired complications associated with prolonged stays.
Bingo! The robot is right on this one.
Reducing LOS is truly something that benefits everyone – patients, caregivers and the financial health of hospitals.
🚑 Barriers to reducing LOS abound
OK. I know what you’re thinking: If reducing LOS is so important, why is doing it such a struggle?
Quite simply, too often there isn’t a good place for a patient to be discharged to.
Some patients don’t need to stay at the hospital, but they have issues that can’t be addressed at home. It could be that the level of care needed is too complex or just challenging to deliver in their home. Perhaps, they don’t have family or friends to care for them or they can’t afford to arrange for in-home care.
In many communities there is limited capacity at skilled nursing or behavioral health facilities to handle the number of patients who need to be discharged. Those patients often remain at the hospital much longer than ideal.
In Oregon, which is where I live, the average hospital inpatient length of stay is 4.6 days. Oregon has about 1.6 hospital beds per 1,000 people, the second lowest per capita rate nationwide.
The state has been battling the discharge situation for years:
“Across a sprawling system of nearly 60 acute-care hospitals, Oregonians take up beds they do not need while other patients board in emergency rooms for days on end with nowhere to go.
Those patients don’t require a hospital anymore but are not well enough to simply walk out. They still need care, like a long-term care facility.
Some are waiting for Medicaid coverage approval to move into a long-term care facility. Others are looking for a homeless shelter to take them in as they continue a recovery from drug addiction.
The clogged system in Oregon affects thousands of people who are not getting the care they need when they need it, including many low-income residents and homeless people.”
The impact on health systems like Providence (where I work) is clear:
“In 2023, Providence Health & Services, Oregon’s largest hospital provider, had patients across its eight hospitals who stayed 5,700 extra days per month when they could have been discharged but weren’t simply because they were stuck there.
For an average five-day stay in a hospital, that translates into an extra 1,140 patients a month. It’s also the equivalent of admitting 37 patients a day and keeping them for five days.
In some hospitals throughout the country the situation is so bad that emergency department patients who need to be admitted to a bed are forced to 'board' in hallways and other common areas of the hospital."
🏥 Why reducing LOS improves financial performance
Most non-profit hospitals exist on an exceptionally low operating margin. Reducing LOS packs an impact on financial performance because patients can move through the hospital more efficiently and incur lower costs for staffing, supplies and more.
This article from Becker’s provides some practical examples:
“The average 425-bed hospital would save more than $20 million per year in operating expenses by cutting out the costs associated with unnecessary days in the hospital.
Moving patients through the hospital quickly opens up additional space for other patients. For a 425-bed hospital with an average $4,500 margin per admission, dropping the length of stay by one day would add $20 million in additional margin because the hospital could accommodate more patients.
Less efficient hospitals may decide to add beds or expand capacity to accommodate patients, which has a hefty price tag. New construction typically costs around $2 million to $3 million per bed.”
👇 The bottom line
For a variety of reasons, hospitals want to release people as soon as they safely can. It’s in the best interests of the patients and staff. And it helps boost financial performance.
Reducing LOS isn’t easy, but it’s critical.
If you remember anything about LOS from this article, remember this simple equation:
Shorter stays are better than longer stays!
🎁 Bonus: A guide to 25 hospital acronyms
For communicators and marketers, much of the insider terminology used in hospitals can be difficult to understand. LOS is just one of many confusing terms you’ll hear.
To help, I’ve put together a guide of 25 terms that you need to know.
Download it here:
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