Improving length of stay: What can hospitals do?

"This report from the Nuffield Trust is part of a larger project undertaken with Monitor designed to test the potential for reducing admissions and length of stay in hospital and the impact this could have on the costs of hospital care and the wider costs of local systems."

Improving length of stay: What can hospitals do?
R Lewis, N Edwards
Nuffield Trust
September 2015

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Effectiveness of an intermediate care hospital

"Having an ICH in the municipality facilitated shorter length of hospital stay and kept the risk of readmissions, mortality and post-hospitalization care needs at the same level as without an ICH."

Effectiveness of an intermediate care hospital on readmissions, mortality, activities of daily living and use of health care services among hospitalized adults aged 60 years and older—a controlled observational study
U Dahl, A Steinsbekk, R Johnsen
BMC Health Services Research, 2015, 15:351

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Geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions

"Policymakers targeting a reduction in unplanned admissions could introduce initiatives to improve primary care access and quality or develop alternatives to admission."

A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions
J Busby, S Purdy, W Hollingworth
BMC Health Services Research, 2015, 15:324

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Effects of librarian-provided services in healthcare settings

"Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case."

Effects of librarian-provided services in healthcare settings: a systematic review
L Perrier, et al.
Journal of the American Medical Informatics Association, 2014, 21(6):1118-1124

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Unexpectedly long hospital stays as an indicator of risk of unsafe care

"The unexpectedly long length of stay (UL-LOS) indicator is a useful addition to other patient safety indicators by revealing variation between hospitals and areas of possible patient safety improvement."

Unexpectedly long hospital stays as an indicator of risk of unsafe care: an exploratory study
I Borghans, KD Hekkert, L den Ouden, S Cihangir, J Vesseur, RB Kool, GP Westert
BMJ Open, 2014;4:e004773

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Community services: How they can transform care

"Significant numbers of patients occupying hospital beds could be cared for in other settings but only if suitable services are available and can be accessed easily."

Community services: How they can transform care
N Edwards
The King's Fund
February 2014

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Increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections

"Bloodstream infections are associated with an increased risk of death and longer hospital stay. Avoiding infections could save lives and free up valuable bed days."

The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections: a case–control study
AG Barnett, K Page, M Campbell, E Martin, R Rashleigh-Rolls, K Halton, DL Paterson, L Hall, N Jimmieson, K White, N Graves
BMJ Open, 2013, 3:e003587

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Time to act: severe sepsis: rapid diagnosis and treatment saves lives

"Better care could lead to savings in 8 Time to act - Severe sepsis: rapid diagnosis and treatment saves lives terms of reduced length of hospital stay and less intensive care and renal dialysis."

Time to act: severe sepsis: rapid diagnosis and treatment saves lives
Parliamentary and Health Service Ombudsman
September 2013

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Elective hospital admissions, waiting times and patient experience

"This Briefing will help non-executive directors (NEDs) better understand NHS data and how it can be used to determine what is going on in their hospital."

The non-executive directors' guide to hospital data: Part two: Elective hospital admissions, waiting times and patient experience
Hospitals Forum briefing
NHS Confederation
May 2013, Issue 263

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Reducing unnecessary hospital days to improve quality of care through physician accountability

"Results indicate that a strategy, involving physician direct accountability, can reduce unnecessary hospital days."

Reducing unnecessary hospital days to improve quality of care through physician accountability: a cluster randomised trial
C Caminiti, et al.
BMC Health Services Research, 2013, 13:14

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Delay in discharge and its impact on unnecessary hospital bed occupancy

"Elderly patients experiencing acute surgical admission and discharge to community hospitals had prolonged length-of-stay due to significant delays associated with care of the elderly provision."

Delay in discharge and its impact on unnecessary hospital bed occupancy
Majeed MU, et al.
BMC Health Services Research, 2012, 12:410

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Older people and emergency bed use

"There is significant variation in the use of hospital beds by people over 65 admitted as an emergency."

Older people and emergency bed use: exploring variation
C Imison, E Poteliakhoff, J Thompson
The King's Fund
August 2012

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English hospitals can improve their use of resources

"The findings suggest that all hospitals have scope to make efficiency savings in at least one of the clinical areas considered by this study."

English hospitals can improve their use of resources: an analysis of costs and length of stay for ten treatments
CHE Research Paper 78
J Gaughan, A Mason, A Street, P Ward
Centre for Health Economics, University of York
July 2012

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Cholecystectomy services redesign: reducing length of stay in hospital

"The benefit of reducing the length of stay by 1 day for patients undergoing laparascopic cholecystectomy saves more than 17,000 bed days across the NHS."

Cholecystectomy services redesign: reducing length of stay in hospital
NHS Institute for Innovation and Improvement
March 2012

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Does competition improve public hospitals' efficiency?

"Our results suggest that competition between public providers prompted public hospitals to improve their productivity by decreasing their pre-surgery, overall and post-surgery length of stay."

Does competition improve public hospitals' efficiency? Evidence from a quasi-experiment in the English National Health Service
Z Cooper, S Gibbons, S Jones, A McGuire
Centre for Economic Performance
February 2012

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Measuring and modelling occupancy time in NHS continuing healthcare

"This paper investigates two areas of concern, namely, how long existing patients stay in service and the number of patients that are likely to be still in care after a period of time."

Measuring and modelling occupancy time in NHS continuing healthcare
S Chahed, E Demir, TJ Chaussalet, PH Millard, S Toffa
BMC Health Services Research, 2011, 11:155

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