El Camino Hospital

El Camino Hospital, a 395-bed community hospital, struggled with high length of stay driven by complex discharge barriers, inconsistent care coordination, and lack of actionable data. Care coordinators managed oversized patient panels without adequate shift or weekend coverage, and the hospital lacked timely visibility into which clinical and operational factors were prolonging stays.

The hospital implemented an enterprise data warehouse and analytics platform (Health Catalyst) to integrate clinical, billing, cost, and quality data into actionable dashboards. A custom 'days stayed' metric replaced ALOS for targeting high-utilization patients. Multidisciplinary daily rounds and twice-weekly outlier rounds were established, discharge planning began at admission, and care coordinator coverage was expanded across all shifts and the ED.

ALOS dropped from 5.24 to 4.83 days (7.8% reduction), readmissions fell from 12.2% to 10.4% (14.8% reduction), and hospital-acquired conditions declined 55% (from 11 to 5 events). AHRQ patient safety indicators fell 32%, and the initiative generated $2.2 million in projected annual cost savings.

• Targeting the highest-utilization outlier patients (those staying 19+ days accounted for 42% of total days stayed) produced outsized impact on overall LOS metrics.
• Data transparency at the unit manager and bedside nurse level broke down siloes and drove behavioral change more effectively than top-down directives.
• Reducing LOS and reducing readmissions are not inherently at odds — a patient-centered discharge process achieved both simultaneously.