SHM Converge Scientific Abstract ePoster Gallery-Individualized Length of Stay: A Novel Metric for Improving Patient Throughput

Pdf Summary

This abstract proposes <strong>Individualized Length of Stay (iLOS)</strong> as an alternative to traditional length of stay (tLOS) in hospital medicine. The authors argue that tLOS is flawed because it often attributes the full hospital stay to the discharging physician, even when multiple clinicians contributed to care. This can create unfair comparisons, reduce motivation to improve throughput, and distort performance measurement.

iLOS is defined as the <strong>number of patient encounters managed by a physician divided by that physician’s number of discharges</strong> over a given period. The authors report implementing iLOS at Atlantic Health System using Epic Clarity SQL data and Power BI. Their method captures the attending physician for each patient at 8 AM, links that to discharge data, and calculates iLOS as the ratio of patient-days managed to discharges completed. They validated the metric internally over two weeks by comparing it with rounding schedules, census assignments, and discharge totals.

The authors claim iLOS has several advantages: it corrects attribution errors, can be calculated daily for real-time feedback, encourages prompt discharge, discourages unnecessary transfers, and may support targeted incentives. They also note that while iLOS changes attribution at the individual physician level, it approximates traditional LOS at the group level, making it potentially useful for both physician-level incentive systems and group-level operational planning.

Overall, the authors advocate for iLOS as a novel metric for improving patient throughput and hospital efficiency, while emphasizing the need for further external validation and study of its clinical and financial effects.

Asset Subtitle

Cyrus Sebastian

Meta Tag

Author List Cyrus Sebastian, Robert Sikora, Sarah Shihadeh

Category Innovations

Concept Traditional Length of Stay

Concept Length of Stay

Concept Individualized Length of Stay

Concept Attribution Error

Concept Hospital Medicine Performance Metric

Distinguished Non-Finalist

Presenter Organization Atlantic Health System

Presenting Author Cyrus Sebastian

Track Quality Improvement

Keywords

individualized length of stay

iLOS

traditional length of stay

hospital medicine

patient throughput

physician performance measurement

Epic Clarity SQL

Power BI

discharge attribution

hospital efficiency

Traditional Length of Stay

Length of Stay

Individualized Length of Stay

Attribution Error

Hospital Medicine Performance Metric