SHM Converge Scientific Abstract ePoster Gallery-Tackling Length of Stay and Complex Care: A Multidisciplinary Model to Reduce Excess Days in an Urban Community Hospital

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Northwell Health, New York State’s largest health care provider and private employer, is committed to high-quality care, education, research, and community service across its hospitals and outpatient network.<br /><br />This document describes a quality improvement project from Northwell’s Division of Hospital Medicine at an urban community hospital in Queens, NY. The hospital serves a diverse, aging population with major socioeconomic barriers that often delay discharge, including limited post-acute placement, insurance authorization delays, and social challenges. These issues led to longer hospital stays and excess inpatient days.<br /><br />To address this, the team launched a proactive multidisciplinary discharge planning model in August 2024. The intervention introduced two structured virtual meetings each week via Microsoft Teams:<br /><br />- Monday Length of Stay Meeting: focused on patients with LOS of 7 days or more and on identifying barriers early.<br />- Wednesday Complex Care Meeting: focused on patients with LOS of 10 days or more or especially complex cases, with the same multidisciplinary team to maintain continuity.<br /><br />Participants included hospitalists, nurse practitioner leadership, surgery leadership, case management, and social work. The meetings emphasized early barrier identification, clear ownership of action items, estimated discharge dates, and real-time escalation.<br /><br />Results showed improved operational performance without harming quality. Average length of stay decreased by 0.32 days (6.8%), and excess days per case dropped by 0.31. Quality measures remained stable or improved: case mix index and 30-day mortality were unchanged, 30-day readmissions decreased by 9.6%, and patient satisfaction improved by 3.6%.<br /><br />The team plans to expand the model with real-time LOS dashboards, refined escalation criteria, broader multidisciplinary use, and continued monitoring of outcomes.

Asset Subtitle

Bryant Faria

Meta Tag

Author List Bryant Faria, Heather Gordon, Isabella Park, Jamina John, John Raimo, Rishi Malhan

Category Innovations

Concept Interdisciplinary approach

Concept Discharge Barrier

Concept Prolonged Hospitalization

Concept Length of Stay

Concept Complex Care

Distinguished Non-Finalist

Presenter Organization Northwell Health

Presenting Author Bryant Faria

Track Quality Improvement

Keywords

Northwell Health

quality improvement

discharge planning

length of stay

multidisciplinary meetings

hospital medicine

case management

social work

patient satisfaction

readmission reduction

Interdisciplinary approach

Discharge Barrier

Prolonged Hospitalization

Length of Stay

Complex Care