Improving utilization and patient care. A rural hospital reduces length of stay through policy revisions and education.

In 1990 Saint Vincent Memorial Hospital, Taylorville, IL, intensified efforts to improve resource utilization. A program of daily case review and medical staff education has helped the hospital reduce average length of stay from between 7 and 8 days to between 5 and 6.8 days. Steps taken to achieve this include: Hiring an outside medical adviser to oversee collection and analysis of data related to length of stay and conduct case reviews Appointing a medical review officer and a physician-specific case manager Establishing a Utilization Management Task Force, which has reformed the policy concerning patients with methicillin-resistant Staphylococcus aureus to ensure discharge in a timely manner; implemented a nonacute-day reporting system; and completed a transitional care study to identify the benefits of transferring medically stable Medicare patients to the Skilled Nursing Facility.