Length of stay reduction: two innovative hospital approaches.

As staffing limitations and reimbursement constraints challenge hospitals to provide effective care, the development of greater clinical efficiency has become imperative. One promising alternative in this area is the reduction in hospital lengths of stay. This study describes two different efforts at length of stay reduction implemented by large general hospitals in Syracuse, New York. One of these programs, implemented by Crouse Hospital, focused on the use of continuum of care guidelines implemented by case managers and nursing staff on a daily basis. The other approach, employed by St. Joseph's Hospital Health Center, focused on the use of physician education and the periodic distribution of individual length of stay profiles. Each of these approaches has generated notable successes in the reduction of inpatient acute care lengths of stay.