Elsevier

Journal of Vascular Surgery

Volume 39, Issue 2, February 2004, Pages 395-399
Journal of Vascular Surgery

Clinical research study from the American Association for Vascular Surgery
System to decrease length of stay for vascular surgery

Presented at the Fifty-first Annual Meeting of the American Association for Vascular Surgery, Chicago, Ill, Jun 8-11, 2003.
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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.

Cited by (0)

Supported by grants from the Anna S. Brown Trust, the New York Institute for Vascular Studies, and the William J. von Liebig Foundation.

Competition of interest: none.