The Challenge
A tertiary hospital was experiencing high inpatient length of stay, with nearly half of admitted patients exceeding their DRG targets. Extended stays reduced bed availability, increased crowding, delayed transfers from emergency and critical care, and resulted in millions in lost revenue.
Despite multiple isolated improvement attempts, the hospital lacked a unified approach to patient flow.
The Approach
A detailed analysis identified contributing factors such as inconsistent discharge planning, unclear team roles, and limited real-time visibility of delays. A high-variance unit was selected as a pilot:
- The SAFER patient flow bundle was implemented to structure daily discharge planning.
- RED2GREEN methodology was introduced to identify non-value-adding days and prompt immediate escalation.
- Teams participated in daily flow discussions to identify barriers and drive same-day action.
- Once successful in the pilot, the model was spread across the full organization.
- Leadership rounding and visual management boards were introduced to sustain daily focus.
The Outcome
The initiative reduced average length of stay from 7.3 to 5.9 days, freeing capacity and improving patient movement across the hospital. Financial benefits exceeded $5.8M. Staff engagement improved as teams gained clearer roles and more predictable workflows.
The project demonstrated that structured daily practices, when consistently applied, can transform patient flow and hospital efficiency.