System to decrease length of stay for vascular surgery

Taylor Reed, Frank J. Veith, Nicholas J. Gargiulo, Carlos H. Timaran, Takao Ohki, Evan C. Lipsitz, Mahmoud B. Malas, Reese A. Wain, William D. Suggs, Sachinder S. Hans, Jerry Goldstone, Peter F. Lawrence, Thomas K. Curry

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives: Reduction of length of stay (LOS) is critical for optimal use of hospital resources. We developed and evaluated a system to aggressively reduce LOS for vascular surgery. Method: Key to this system, which we introduced on January 1, 2001, was appointment of a LOS officer, who communicated daily during hospitalization with patients and families about discharge planning, organized outpatient services for wound care and rehabilitation to transition patients quickly to nonhospital care, and had biweekly meetings with relevant paramedical services. LOS for 509 patients operated on in 2000 (standard group) was compared with LOS for 474 operated on in 2001 and 595 patients operated on in 2002 (LOS reduction groups). Data for all patients with aortic aneurysm, carotid artery stenosis, lower extremity critical ischemia or amputation, and foot debridement were included. Results: LOS in 2000 averaged 8.5 days, compared with 5.9 days in 2001 and 5.6 days in 2002. All decreases in LOS for each diagnostic category in 2001 and 2002 were statistically significant (P = < .001-.03). There was no significant increase in readmission rate (2.2% vs 1.9% and 2.0%, respectively), mortality rate (0.8% vs 0.6% and 0.7%, respectively), or percent of patients who received endovascular treatment (18% vs 16% and 14%, respectively). These decreases in LOS saved the hospital more than $616,200 in 2001, and $847,550 in 2002 ($500/patient-day). Conclusions: A committed LOS officer with major specific daily responsibilities for decreasing LOS and discharging patients resulted in a 31% to 33% decrease in LOS, with important cost savings to the hospital and no negative effect on patient care.

Original languageEnglish (US)
Pages (from-to)395-399
Number of pages5
JournalJournal of Vascular Surgery
Volume39
Issue number2
DOIs
StatePublished - Feb 2004

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Blood Vessels
Length of Stay
Patient Transfer
Cost Savings
Patient Discharge
Aortic Aneurysm
Carotid Stenosis
Debridement
Ambulatory Care
Amputation
Foot
Lower Extremity
Patient Care
Appointments and Schedules
Hospitalization
Rehabilitation
Ischemia
Mortality
Wounds and Injuries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Reed, T., Veith, F. J., Gargiulo, N. J., Timaran, C. H., Ohki, T., Lipsitz, E. C., ... Curry, T. K. (2004). System to decrease length of stay for vascular surgery. Journal of Vascular Surgery, 39(2), 395-399. https://doi.org/10.1016/j.jvs.2003.09.015

System to decrease length of stay for vascular surgery. / Reed, Taylor; Veith, Frank J.; Gargiulo, Nicholas J.; Timaran, Carlos H.; Ohki, Takao; Lipsitz, Evan C.; Malas, Mahmoud B.; Wain, Reese A.; Suggs, William D.; Hans, Sachinder S.; Goldstone, Jerry; Lawrence, Peter F.; Curry, Thomas K.

In: Journal of Vascular Surgery, Vol. 39, No. 2, 02.2004, p. 395-399.

Research output: Contribution to journalArticle

Reed, T, Veith, FJ, Gargiulo, NJ, Timaran, CH, Ohki, T, Lipsitz, EC, Malas, MB, Wain, RA, Suggs, WD, Hans, SS, Goldstone, J, Lawrence, PF & Curry, TK 2004, 'System to decrease length of stay for vascular surgery', Journal of Vascular Surgery, vol. 39, no. 2, pp. 395-399. https://doi.org/10.1016/j.jvs.2003.09.015
Reed, Taylor ; Veith, Frank J. ; Gargiulo, Nicholas J. ; Timaran, Carlos H. ; Ohki, Takao ; Lipsitz, Evan C. ; Malas, Mahmoud B. ; Wain, Reese A. ; Suggs, William D. ; Hans, Sachinder S. ; Goldstone, Jerry ; Lawrence, Peter F. ; Curry, Thomas K. / System to decrease length of stay for vascular surgery. In: Journal of Vascular Surgery. 2004 ; Vol. 39, No. 2. pp. 395-399.
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AU - Veith, Frank J.

AU - Gargiulo, Nicholas J.

AU - Timaran, Carlos H.

AU - Ohki, Takao

AU - Lipsitz, Evan C.

AU - Malas, Mahmoud B.

AU - Wain, Reese A.

AU - Suggs, William D.

AU - Hans, Sachinder S.

AU - Goldstone, Jerry

AU - Lawrence, Peter F.

AU - Curry, Thomas K.

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N2 - Objectives: Reduction of length of stay (LOS) is critical for optimal use of hospital resources. We developed and evaluated a system to aggressively reduce LOS for vascular surgery. Method: Key to this system, which we introduced on January 1, 2001, was appointment of a LOS officer, who communicated daily during hospitalization with patients and families about discharge planning, organized outpatient services for wound care and rehabilitation to transition patients quickly to nonhospital care, and had biweekly meetings with relevant paramedical services. LOS for 509 patients operated on in 2000 (standard group) was compared with LOS for 474 operated on in 2001 and 595 patients operated on in 2002 (LOS reduction groups). Data for all patients with aortic aneurysm, carotid artery stenosis, lower extremity critical ischemia or amputation, and foot debridement were included. Results: LOS in 2000 averaged 8.5 days, compared with 5.9 days in 2001 and 5.6 days in 2002. All decreases in LOS for each diagnostic category in 2001 and 2002 were statistically significant (P = < .001-.03). There was no significant increase in readmission rate (2.2% vs 1.9% and 2.0%, respectively), mortality rate (0.8% vs 0.6% and 0.7%, respectively), or percent of patients who received endovascular treatment (18% vs 16% and 14%, respectively). These decreases in LOS saved the hospital more than $616,200 in 2001, and $847,550 in 2002 ($500/patient-day). Conclusions: A committed LOS officer with major specific daily responsibilities for decreasing LOS and discharging patients resulted in a 31% to 33% decrease in LOS, with important cost savings to the hospital and no negative effect on patient care.

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