Benchmarking and clinical pathway implementation on a multihospital basis.

Hospital utilization data for communities with high levels of managed care penetration can be readily used to develop utilization benchmarks in any proactive efforts to prepare for oncoming prospective pricing system (PPS) initiatives. In a cooperative effort among all four Syracuse, NY hospitals, the combined average hospital LOS for one surgical and three medical DRGs was compared with benchmarks derived from similar populations in three heavily managed care-penetrated west coast communities. Implementation of clinical or critical paths are a widely accepted approach to shortening hospital lengths of stay and improving both resource usage and clinical outcomes. After implementing clinical paths across all four institutions and revisiting their data a year later, a fairly dramatic reduction (28%) in mean LOS for total hip replacement procedures was achieved. Two of the three medical DRGs, stroke and acute MI, each showed a mean reduction of 17% in LOS.