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Highland Hospital improves communication to reduce length of stay

Reducing patients’ length of stay in hospital settings correlates strongly with improved care quality and outcomes. In 2018, Highland Hospital (a member of UR Medicine) began implementing a variety of initiatives to decrease LOS by improving face-to-face, effective communication among its team members.

First, Highland Hospital identified environmental barriers to effective communication including competition for time and attention in different areas of the hospital, organizational complexity and power relationships. To resolve these barriers, staff implemented three interventions to increase face-to-face communication between nurses and physicians on one medical unit: a location-based hospitalist and advanced practice provider team assignment, bedside rounding and a daily interdisciplinary huddle.

Data were gathered and compared before and after the implementation of these interventions, including measuring LOS and discharges before noon, face-to-face communication data collected by polling the nurses and interdisciplinary huddle compliance.

From these interventions the mean LOS decreased by 1.1 days post implementation (7.7 versus 6.6) and median LOS decreased by nine hours.

Of the nurses polled post implementation, 93% felt they made contributions to the plan of care versus 12% before implementation. Additionally, the number of pages received by advanced practice providers decreased by 51%.

For more information, contact Sullafa Kadura, MD, MBA, medical director, at sullafa_kadura@urmc.rochester.edu or 585.341.6897.