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LOS Revisited

Written by: Bob Habasevich, PT on Wednesday, November 19, 2014 Posted in: Inpatient Rehab

Monitoring the Patient’s Payment Clock: How Care is Prioritized

Rehabilitation hospitals have routinely valued length of stay (LOS) as a key metric for assessing hospital performance both clinically and financially. Tracking, reporting and comparing LOS has occupied the past times for many administrators seeking the strategic advantage to improve performance.

Recently, I was bemused by an industry report of the benefits of using LOS data to influence clinician decisions and behaviors in two New York hospitals. Apparently, publishing the LOS in a medical record and performing simple calculations of when the patient was admitted and how much longer he has before discharge actually influences how physicians practice in the hospital. This information serves as hourglass reference enabling clinicians to realize how much time is left on this patient’s payment clock. With this information, care is reprioritized and adjusted to accommodate available resources and requirements.

Why this seems a novel concept for acute hospitals is surprising. There is not a care conference or planning meeting taking place in the rehab hospital without reference made to one of the 353 ALOS published annually by CMS. Moreover, while not an exact science, calculations for what needs to be accomplished, and by when are expressed in terms of planned discharge for each patient. MediLinks® has routinely featured this ability since 2008. Perhaps giving credit for the electronic medical record’s meaningful use of these data is noteworthy and cause for recognition of its ability to influence patient care. It certainly will not hurt in attesting to Stage 2 compliance criteria.

Looking forward to other meaningful advances with integration of technology and clinical practice I wonder other what other rehab practices will be next to find their way into the acute hospital electronic medical record. Perhaps patient problem related goals.