UCLA Health Cuts Hospital Stay by 2.5 Days with New Discharge System

A new pilot study at UCLA Health has demonstrated that a standardized approach to hospital discharges significantly reduces the time patients spend in hospital. This innovative system cut discharge waiting times by nearly 50% for four common medical diagnoses and resulted in an average reduction of 2.5 days in hospital stays. The findings, published in BMJ Open Quality, highlight a potential solution for hospitals struggling with bed capacity and slow patient throughput.

Over an 18-month period, the study focused on four neurological and medical conditions: transient ischemic stroke, seizures, demyelinating diseases, and syncope (fainting). The Ronald Reagan Medical Center at UCLA implemented the discharge improvement program by developing consensus-based criteria for discharges, informed by stakeholders involved in the patient’s journey from admission to discharge.

The results were significant. The median time from discharge orders to actual discharge decreased from 171 minutes to 88 minutes, representing a 49% reduction. Additionally, the overall median length of stay in the hospital dropped by 2.5 days. These improvements were not short-lived; six months after the implementation, median discharge times stabilized at 92 minutes, with the median hospital stay further declining to 30 hours.

Dr. Melissa Reider-Demer, the study’s lead author and a member of UCLA Health, emphasized the importance of this new system. “We replaced arbitrary, physician-specific discharge decisions with consensus-based criteria developed by neurology and medicine specialists,” she stated. This shift allowed the care team—including nurses, pharmacists, case managers, and transport staff—to predict and coordinate discharges more efficiently.

The study monitored 318 patient visits across UCLA Health’s emergency, observation, and inpatient neurology units. Researchers began by establishing baseline measurements of discharge times and lengths of stay over six months before implementing the new criteria. Following the change, more than 80% of patients were discharged within two hours of orders being placed.

The positive effects of this initiative continued beyond the study, with hospital readmission rates remaining low at approximately 1.5% in the emergency room. The transition from arbitrary, time-based discharge decisions to a standardized, consensus-based approach has garnered support from the nonprofit health care organization, the Institute for Healthcare Improvement.

Dr. Reider-Demer explained that previously, doctors had different thresholds for determining when patients were ready for discharge. By establishing clear, consensus-driven criteria, the new system minimizes delays stemming from individual provider preferences and enhances the efficiency of the discharge process.

While the consensus-based discharge criteria were specifically designed for UCLA, Dr. Reider-Demer believes that the framework can serve as a template for other hospitals addressing similar health conditions and operational challenges. This study underscores the potential for standardized systems to improve patient flow and overall hospital efficiency, a pressing need in today’s healthcare environment.

As health systems continue to adapt in response to increasing patient volumes, the findings from UCLA Health may offer valuable insights for hospitals worldwide, paving the way for improved patient outcomes and streamlined operations.