The Challenge
The hospital’s administration challenged the ApolloMD Hospitalist team to lower the Geometric Mean Length of Stay, Observed Over Expected (GMLOS O/E), which was averaging around 1.25. Administration’s goal was 1.05.
Dramatic Decrease in GMLOS O/E
New Administrative Medical Director Role brings remarkable change within 3 months
Background
Hospitalist Medical Director Dr. Lynn Crawford sought to bring change to her department in a 434-bed, tertiary care hospital in a major metropolitan city. A collaboration with hospital administration resulted in the development of a new role: Administrative Medical Director. Dr. Crawford decreased her clinical shifts to allocate sufficient time to focus on process and metric improvement. Drastic results within three months proved the success of the new role.
The Approach
Dr. Crawford’s traditional 12-hour clinical rotation schedule transitioned to full-time “office hours” to maximize her time on-site and allow availability for meetings. This transition quickly led to her involvement across various departments, committees, and projects throughout the hospital, extending beyond her own department. Other departments began seeking her medical insights and assistance on projects and issues. She has become a strong advocate for a change-oriented mindset and a leader in driving process improvement initiatives.
In her role as Administrative Medical Director, Dr. Crawford is a valuable asset to her team because of the additional time she is available to assist with complex cases and implement improvements. By actively participating in site-wide rounds and huddles, she provides her team with prompt solutions and patient updates. With the initial goal from administration to reduce GMLOS, her efforts immediately delivered results: in the first month alone, the department’s GMLOS dropped from 1.25 to 1.19.
“This is a new, innovative role that has helped decrease our GMLOS by 0.2 in just three months which over a year could equate to millions of dollars. It’s a great way we’ve been able to work with administration and really drive LOS and flow for the hospital.”
The Results
Dr. Crawford’s role transition is considered a success, and she is regarded as a model Administrative Medical Director at ApolloMD.
- The department’s GMLOS O/E fell from 1.25 to 1.06 (almost a half-day reduction from the starting point) and continues to decrease.
- IDT rounds now take only 15 minutes, covering approximately 50 patients.
- The number of patients on the “Long LOS Watch” list dropped from an average of 30 to 18.
- Site-wide collaboration improved, with teams working more cohesively toward common goals.
- Clinically appropriate policies and procedures were updated and are now used by the entire organization.
Dr. Crawford’s focus on changes and improvements positively impacted the Hospital Medicine team as well as the entire hospital. Her active involvement in rounding and huddles has led to proactive and timely responses to patient needs. Dr. Crawford’s team values the additional support she provides in managing complex cases and driving necessary improvements.