- Definition, Causes, Symptoms & Treatment, What Is Pneumonia? The discussion about length of stay now resumes. JAMA . Learn more about SONIFI Health’s interactive solutions and our impact on Length of Stay here. Reducing length of stay by enhancing patients’ discharge: a practical approach to improve hospital efficiency. The manager provides the reasoning for accurate data measuring and why they are always auditing charts and reviewing plans of care and interventions. We're a leader in interactive patient engagement solutions, a proven technology integrator and a trusted service partner. However, managing length of stay (the amount of time an animal is at the shelter), is essential to increasing your life-saving success. This lesson will discuss the various aspects involved in utilizing length of stay measures in healthcare. 157-160). Data included three years of medical records (n=7,574) from a non-profit hospice in the Pittsburgh, PA area. 2. While it’s true that chainstay length has an important impact on all those aspects of a bike’s character, stay length is only one factor in more than 200 design parameters that go into developing an ideal bike. The ALOS refers to the average number of days that patients spend in hospital. Let's say you operate a shelter with 5 dog kennels in it. The surgical unit at Mercy Hospital is trying to reduce costs and length of stay for patients. However, LOS had to be 1 full day below the average before it had a negative impact on readmissions, suggesting that there is still room for improvement. For this reason, analyzing the LOS outliers is fundamental for the management and financing of hospitals. They provide patients with … Reduction in the number of inpatient days results in decreased risk of infection and medication side effects, improvement in the quality of treatment, and increased hospital profit with more efficient bed management. All other trademarks and copyrights are the property of their respective owners. The ACA touched on many different aspects of healthcare, including: The manager of the surgical unit explains to her staff that these changes affect how the hospital gets reimbursed through private health insurance companies, Medicare, and Medicaid. Thankfully, there is software to compute this data, and even perform a certain degree of analysis. Bueno H, Ross JS, Wang Y, et al. Stay stitching is only for reinforcement—it will not be seen on the outside of the garment unless you accidentally sew over a seam line. However, from the position that it is not necessarily an appropriate index in Japan, an analysis is made of the difference in the health care facility system between the United States and Japan. This study examined the factors that influence length of stay at a local non-profit hospice organization. Inaccurate measuring and reporting of length of stay may delay reimbursement or make it appear that the hospital is not meeting benchmarks even when they are. Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator. Let's take a very small example. In J. Mantas, A. Hasman, P. Gallos, & M. S. Househ (Eds. In this article, we investigate the relationship between hospital length-of-stay (LOS) and quality of care. The manager of the unit starts a discussion with her nurses and doctors to see how they are treating patients and what can be done differently. Several factors that are reviewed when looking at length of stay include: Get access risk-free for 30 days, Reduction in the number of inpatient days results in decreased risk of infection and medication side effects, improvement in the quality of treatment, and increased hospital … Average length of stay, all hospitals Indicator code: E992901.T Total number of occupied hospital bed-days divided by the total number of admissions or discharges. CONCLUSIONS: There is significant variation among hospitalists in length of stay and discharge destination of their patients, but much of the variation is attributable to the hospitals where they practice. So understandably, the more patients are involved with and aware of their anticipated Length of Stay, the better they will report their experience and their care team’s ability to communicate. The study of length of stay (LOS) outliers is important for the management and financing of hospitals. The length of stay and discharge days is an important indicator of the efficiency of hospital management. 992901, except that only short-stay hospitals are taken into account (see also WHO indicator no. ER patients' length of stay is one of the most important indicators for performance monitoring as well as improvement. Patients in these situations rightfully feel anxious and frustrated with the flow of information. study Benchmarking is a process that allows for a comparison to be made to other organizations by creating a standard of excellence such as quality of care, reducing expenditures, and decreasing length of stay, and using the comparison to make improvements. In today’s tourist markets, a declining average stay is observed in tourism length of stay. Get our newsletter and receive exclusive product details, research and industry news. I am sure many of you have heard me rant about observation rates before. The more important number is the length of stay index. Keep the length of two grocery carts between you and other shoppers. For example, ML predictions can help healthcare providers determine the likelihoods of disease, aid in the diagnosis, recommend treatment, and predict future wellness. Reducing hospital length of stay (LOS), especially as it relates to avoiding unnecessary hospital-acquired conditions (HACs), is a primary … {{courseNav.course.mDynamicIntFields.lessonCount}} lessons - Definition, Causes, Symptoms & Treatment, What Is Pleurisy? Having awareness into their role with the discharge process, and the anticipated amount of time they must complete these activities, our evidence has shown that patients respond with improved activation and follow through when they are more aware and reminded of these responsibilities through the care process. Length of stay is commonly used as a quality metric. ALOS (Average length of stay) should preferably be provided to the accuracy of hundreds, i.e. Log in or sign up to add this lesson to a Custom Course. Visit the Health 308: Healthcare Quality & Outcome Measurement page to learn more. This trend goes hand in hand with an increasing frequency of trips throughout the year (Martinez-Garcia &Raya, 2008; Yang & Liu, 2003). EXECUTIVE SUMMARY. Shelter-in-place and stay-at-home orders related to the COVID-19 pandemic have gone into effect in different areas of the U.S. We use hospital claims records from Medicare beneficiaries in Michigan to estimate condition-specific models for predicting patients' LOSs. Why is Length of Stay Important? A length of stay that was longer or shorter than average was associated with increased risk of readmission, the researchers found. | SONIFI Health, Khalifa, M. (2017). 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Length of stay is thought to be a major indicator of efficiency of care. Initiate daily multidisciplinary rounding and daily bed huddles: Track patient progress daily so you … Therefore, when a patient is well enough to receive care outside of the hospital, they should be discharged and managed in a less costly way. Measure Category: The idea of "no kill" continues to be a misunderstood idea, and a somewhat divisive one. It is a common question that nearly every admitted patient has, “when do I get to leave?” The patient’s length of stay is important to not only the patient, but also to their family members and their care team. One nurse offers the suggestion to create a committee that meets weekly to review data about the length of stay and care for their patients. … The prospective payment system in U.S. Medicare for reimbursing hospital care promotes shorter length of stay by paying the same amount for procedures, regardless of days spent in the hospital. Length of Stay. length of stay: the period of time a patient remains in a hospital or other health care facility as an inpatient. But I would argue that the length of stay in days is a meaningless number. To learn more, visit our Earning Credit Page. The Affordable Care Act (ACA) was enacted in 2010 to make health insurance more available and affordable for the public and to improve health care options, availability, and care. Benchmarking is used to compare organizations in various aspects including length of stay, cost of treatment, and quality of care. Imagine being a patient not knowing how long you will be in the hospital or only being given the same general answer each time you ask. 1 Length of stay (LOS) is an aspect of care that can be costly for most healthcare systems if not approached the right way. Services. Length of Stay This measure allows organizations to systematically assess the impact of implementing health information technology (health IT) with the intent to decrease inpatient length of stay (LOS). The average length of stay in hospitals is often regarded as an indicator of efficiency. Not only does improving the length of stay show a positive correlation with patient outcomes, but improved length of stay also improves the efficiency of hospital operations. Background and purpose: Very few studies have focused on patient characteristics that influence length of stay (LOS) in fast-track total hip (THR) and knee arthroplasty (TKR). Appropriate length of stay is important in reducing re-admissions and lowering the overall cost of an episode. Length of stay does not correlate directly with costs. 6 Although the influence of many clinical factors on LOS is both intuitive and supported by data, studies from … NRS Length of Stay and Length of Stay Efficiency of Inpatient Rehabilitation Clients. Dysphagia: reference to a patient group with impaired oral and/or pharyngeal swallowing (oropharyngeal dysphagia). Sciences, Culinary Arts and Personal While the hope is everyone voluntarily complies with these types of orders, having a formal executive order allows some ability for governments to regulate movements of people and closure of businesses in order to slow the spread of COVID-19. In this edition of Hospital Economics, Martin Gold discusses whether or not reducing hospital length of stay is an important value proposition for your medical technology. March 8, 2018. © copyright 2003-2020 Study.com. Length of stay is a variable of public health significance as it affects quality of life at the end of life and healthcare expenditures associated with end of life care. Analysis. Average length of stay is important because it can provide a measure of efficiency within each hospital. Accurate documentation and reporting is significant in determining the correct length of stay value and how to decrease it. The longer the stay the higher is the risk to contract an infection. Creating an environment where the patient has awareness to their anticipated length of stay has a positive return on that patient’s experience, preparedness and outcomes as well as hospital efficiency. If these are the same dates, then LOS is set to one day. LOS is determined by a complex interweaving network of multiple supply and demand factors which operate at macro-, meso-, and micro-levels. Length of stayis thought to be a major indicator of efficiency of care. In many cases, hospitals do not receive additional reimbursement once a patient’s stay … Fun Fact . There are several ways to measure length of stay, but basically it is measured by dividing the number of patient admission days in the hospital by the number of patients that were admitted. Bias-Cut Fabric . Length of stay does not correlate directly with costs. This measure allows organizations to systematically assess the impact of implementing health information technology (health IT) with the intent to decrease inpatient length of stay (LOS). Study.com has thousands of articles about every A patient's length of stay should be discussed several times a day in order to make adjustments to the care they are receiving. 1-5 The American College of Surgeons Committee on Trauma uses LOS as an example outcome measure for a performance improvement program. The goal of case managers is to ensure that care for these patients is efficient and smooth, but sometimes there are some pretty big barriers in the way of a smooth discharge to the next level of care. Moreover, the length of stay is an important measure of resource utilization. Appropriate length of stay is important in reducing re-admissions and lowering the overall cost of an episode. If a patient is stable enough for discharge or transfer, then any extension of a hospital stay is unnecessary and increases the chances of adverse events to occur which can further prolong the stay. A common statistic associated with length of stay is the average length of stay (ALOS), a mean calculated by dividing the sum of inpatient days by the number of patients admissions with the same diagnosis-related group classification. Length of stay is measured dividing patient days with the number of patients admitted based on their diagnosis. Considerable heterogeneity prevented meta-analysis of length of stay and hospital … Amsterdam: IOS Press. LOS is defined as the time betwe… (Studies in Health Technology and Informatics; Vol. Average length of stay, acute care hospitals only Indicator code: E992911.T Same as WHO indicator no. The ALOS refers to the average number of days that patients spend in hospital. Shortened length of stays have shown evidence to being positively correlated with improved outcomes. In-hospital infections being exposed to different antibiotics develop resistance to some of them and that makes it more difficult to fight those hospital acquired infections. The longer a patient stays in the hospital, the greater the risk of a hospital-acquired infection, further increasing the length of stay and healthcare costs. ©2020 SONIFI® Health Incorporated. All rights reserved. average length of stay than truly representative since patients staying in the facility from year to year will not be reflected. Get the unbiased info you need to find the right school. Length of stay in the hospital is measured by how many days a patient is hospitalized in relation to what their admission diagnosis is. | {{course.flashcardSetCount}} Sober living homes provide a convenient in-between where recovering patients can stay before going out on their own. Ensuring the delivery of appropriate care and treatment is crucial for quality of care; length of stay in hospital may be irrelevant to this process. The two methodologies which are commonly used to achieve this differ in their accuracy and complexity. Create an account to start this course today. For people coming out of alcohol rehab, transitioning to everyday work or school routines can be a problem. Often times this is categorized by the diagnosis of each patient to compare the length of stay with other organizations. The study of length of stay (LOS) outliers is important for the management and financing of hospitals. However, if the hospital does better than the benchmark, it is seen as the patient received excellent care and may result in increased reimbursement. The goal of case managers is to ensure that care for these patients is efficient and smooth, but sometimes there are some pretty big barriers in the way of a smooth discharge to the next level of care. If you have a disability and would like CIHI information in a different format, visit our Accessibility page. The ACA has brought to light the importance of collecting data and using quality and outcome measures to determine how well an entity is performing. An adequate length of stay during hospitalization is a critical factor in quality of care and a predictor of future readmission risk, according to a new study from The University of Texas at Dallas. Please don’t stop reading, as this has tremendous importance for physicians. 1-5 The American College of Surgeons Committee on Trauma uses LOS as an example outcome measure for a performance improvement program. Creating an environment where the patient has awareness to their anticipated length of stay has a positive return on that patient’s experience, preparedness and outcomes as well as hospital efficiency. I’m sure at least half of you have been told that your observation rate is too high and that you need to fix it. 1 Length of stay (LOS) is an aspect of care that can be costly for most healthcare systems if not approached the right way. When clinically viable, reducing hospital length of stay has been proven to provide both positive results for patients and financial benefits for the institution. By better preparing the patient for discharge, efficiencies are then gained by improving the time between the decision of the date and time of discharge, when the order is placed, when the patient leaves the room, and preparing the bed for the next patient.1 Improving this process means that care team members are not diverting their attention away from admitted patients in order to turn a room around, and the hospital can reduce the rate of patients in wait. Length of hospital stay The average length of stay in hospitals (ALOS) is often used as an indicator of efficiency. credit-by-exam regardless of age or education level. - Definition, Types, Symptoms & Treatment, What Is Postural Drainage? length of stay: the period of time a patient remains in a hospital or other health care facility as an inpatient. Accurate calculation of hospital length of stay (LOS) from the English Hospital Episode Statistics (HES) is important for a wide range of audit and research purposes. first two years of college and save thousands off your degree. We found limited low and very low quality data which were all over 30 years old. Understanding statistics for length of stay, bed turnover, occupancy ratio, etc. Many hospitals have used or still use length of stay for managing the efficiency of resource utilization Prospective payment schemes in health care often include special funding for cost outliers. 2. One nurse asks why they need to make changes, so the manager summarizes expectations from the Affordable Care Act. Patients that complete their discharge activities, including education, have shown to have reduced length of stays and improved discharge times. The ACA has brought to light the importance of collecting data and using quality and outcome measures to determine how well an entity is performing. WHY LENGTH OF STAY MATTERS. The importance of managing length of stay in maximizing life-saving. by Dr. Arun Mohan MD, MBA Do the math and it’s easy to understand why hospital medicine grew so quickly. The surgical unit staff now has a greater understanding of the importance of length of stay and how it is viewed by the organizations that provide financial reimbursement for many of their patients. Providers, patients, families, and community programs need to communicate about plans of care to streamline interventions. A variation in the calculation of ALOS can be to consider only length of stay during the period under analysis. All else being equal, a shorter stay will reduce the cost per discharge and shift care from inpatient to less expensive post-acute settings. Enrolling in a course lets you earn progress by passing quizzes and exams. The Centers for Medicare and Medicaid Services (CMS) use benchmarks to help determine reimbursement rates. ), Informatics empowers healthcare transformation (Vol. Length of Stay. Clearly, a lower ALOS is better for patients, who decrease their risk of developing conditions beyond … Select a subject to preview related courses: The surgical staff is energized and motivated to use this information to increase the patient's experience while decreasing their length of stay. Earn Transferable Credit & Get your Degree. We compare these methods and make recommendations on when each is most appropriate. I need to run a median split on the length of stay variable to have an equal amount of groups (i.e. In trying to reduce overall costs, it may be time to revisit length of stay. I’m sure at least half of you have been told that your observation rate is too high and that you need to fix it. Accurate measurement of length of stay is affected by delay of data collection, disorganized interventions, and financial inefficiencies. The purpose of this study was to determine which factors are associated with length … There are several … Time to service . Moreover, the length of stay is an important measure of resource utilization. Length of stay is an important aspect of patient care because it helps determine if a patient is being treated appropriately. The homes are a bridge between rehab and the real world. The same stitching width and length that will be used to construct the garment can be used for stay stitching. Hospital inpatient care makes up nearly one-third of all healthcare expenditures in the United States, and represents a significant impact on the country’s economy. They can audit charts and discuss what worked with the plan of care and what can be improved. All other things being equal, a shorter stay will reduce the cost per discharge and shift care from inpatient to less expensive post-acute settings. If you have a disablity and would like CIHI information in a different format , visit our Accessibility page. Longer length of stay has contributed greatly to these rising healthcare costs, and in today’s value-based care environment, the pressure is on to understand how to best provide efficient care while also providing quality care. If a patient is stable enough for discharge or transfer, then any extension of a hospital stay is unnecessary and increases the chances of adverse events to occur which can further prolong the stay. and career path that can help you find the school that's right for you. Therefore, reimbursement rates may decrease. Not sure what college you want to attend yet? Log in here for access. Hospitals report their length of stay (in days) as a standard administrative metric. Anytime we put too much emphasis on one design element at the sacrifice of others, the result is a sub-optimal riding experience. 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The length of stay (LOS) is an important indicator of the efficiency of hospital management. The aim of this prospective study was to identify patient characteristics associated with LOS and patient satisfaction after total hip and knee replacement surgery. Therefore, when a patient is well enough to receive care outside of the hospital, they should be discharged and managed in a less costly way. All other things being equal, a shorter stay will reduce the cost per discharge and shift care from inpatient to less expensive post-acute settings. flashcard set{{course.flashcardSetCoun > 1 ? Unlike basting or ease stitches, stay stitching is not removed. However hospitals continue to look for opportunities to improve […] The case mix index is a way of adjusting for how sick … Shelter-in-place and stay-at-home orders related to the COVID-19 pandemic have gone into effect in different areas of the U.S. Longer stays result in higher costs and extra burdens on patients and their families. The national average for a hospital stay is 4.5 days, according to the Agency for Healthcare Research and Quality, at an average cost of $10,400 per day. just create an account. Changing the patient experience starts with knowledge and inspiration. Length of stay (LOS): mean or median number of patient days between a formal admission to, and a formal separation from a hospital care environment . It is important to be aware that the two methods of calculating length of stay are both valid in most instances. {{courseNav.course.topics.length}} chapters | Our aim was to study variables associated with high LOS outliers and their evolution over time. The length of stay is one of the key elements in a tourist’s decision-making process (Bull 1995) and … https://doi.org/10.3233/978-1-61499-781-8-157. Or imagine being told you will need to be in the hospital longer when the anticipated date arrives. 9,000 cases had a length of stay from 0-387 days and 9,000 cases had a length of stay … Predictive analytics is an increasingly important tool in the healthcare field since modern machine learning (ML) methods can use large amounts of available data to predict individual outcomes for patients. In an adjusted analysis of 129 VA hospitals over 14 years, published in Annals of Internal Medicine in December 2012, researchers found that an intense focus on efficiency led to decreases in both LOS (down 27%) and 30-day readmissions (down 16%) as well as fewer deaths from any cause at 30 and 90 days after admission. credit by exam that is accepted by over 1,500 colleges and universities. While the hope is everyone voluntarily complies with these types of orders, having a formal executive order allows some ability for governments to regulate movements of people and closure of businesses in order to slow the spread of COVID-19. Egawa H. The average length of stay is essentially an important and appropriate index for hospital bed administration. “You’re above the benchmark rate” is what you probably heard. This metric measures the time it takes from when the patient arrives at the hospital to when the patient receive healthcare services, including the amount of time it takes to see either a nurse or a doctor. The patient’s length of stay is important to not only the patient, but also to their family members and their care team. For this reason, analyzing the LOS outliers is fundamental for the management and financing of hospitals. 238). The effects of hospital care and the length of stay is important for mental health policy. Reduction in the number of inpatient days results in decreased risk of infection and medication side effects, improvement in the quality of treatment, and increased hospital profit with more efficient bed management. The Patient Protection and Affordable Care Act (ACA) was enacted in 2010 under President Barack Obama. Patients with a long length of stay (LOS) can be a challenge for case managers. The average length of stay (ALOS) in a hospital is used to gauge the efficiency of a healthcare facility. Create your account, Already registered? The hospital needs to try to reduce the length of stay for patients while providing quality care and reducing costs. And, amongst important-yet-vexing quality improvement goals, reducing length of stay (LOS) has to be the granddaddy of them all. Bed-days of newborns are excluded in the calculation. According to an article from Health Catalyst, inpatient hospital stays are estimated to cost the healthcare industry 377.5 billion dollars annually. Quiz & Worksheet - What is a Work Package? I am sure many of you have heard me rant about observation rates before. “You’re above the benchmark rate” is what you probably heard. The relationship between length of in-hospital stay (LOS) and quality of care is difficult. Now, let's say that on average, dogs at your shelter stay there for 30 days. imaginable degree, area of Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice. 992763). While we made tremendous progress in 2018 (thank you! Successful use of technology can help make the patient stay more comfortable, more effective and shorter. With that introduction, let’s focus on Length of Stay (LOS). Consumer-Directed Healthcare: Role & Impact, Quiz & Worksheet - LOS Measures & Healthcare, Over 83,000 lessons in all major subjects, {{courseNav.course.mDynamicIntFields.lessonCount}}, Lowering Healthcare Costs & Increasing Quality & Efficiency: Complexity & Debate, Health 308: Healthcare Quality & Outcome Measurement, Biological and Biomedical 's' : ''}}. When length of stay benchmarks are not met, it is seen as the patient did not receive the correct care to get them discharged in a timely manner based on their admitting diagnosis. Recent research suggests that improvements in efficiency during the inpatient stay can lower LOS without increasing unnecessary readmissions. In today’s value-based care environment, hospitals are under increasing pressure to avoid patient harm and maintain quality while also lowering costs. 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Let’s bring your technology to life to create the best experience for your patients and clinicians. Hospital inpatient care makes up nearly one-third of all healthcare expenditures in the United States, and represents a significant impact on the country’s economy. A hospital’s ability to control length-of-stay (LOS) is directly related to patient satisfaction and profitability…two reasons why healthcare system CEOs include LOS reduction among their top priorities. Accurate documentation and reporting of patient care and intervention is important when determining length of stay. 2010;303(21):2141-2147. Why Length-of-Stay Is Important to Hospital Managers. are important aspects of ensuring a functional, and profitable hospital that is able to serve patients optimally. - Definition, Therapy Techniques & Positions, What Is Pulmonary Edema? Data must be present to support interventions and care provided. Multiply the 14-17% reduction in length of stay achieved by hospitalists by the number of admissions a hospitalist does annually and the value proposition becomes clear. Delivering an interactive technology platform proven to improve patient experience, health outcomes and hospital productivity. You can test out of the Length of stay (LOS) of one patient = date of discharge - date of admission. Patients with a long length of stay can be a challenge for case managers. The average length of stay in hospitals (ALOS) is often used as an indicator of efficiency. Length of stay (LOS) has been suggested as a meaningful outcome measure that is a potential target for quality improvement activities. courses that prepare you to earn Patient engagement is about connecting patients and providers – technology can help, but it must be tied to key outcomes to matter. Although Method 1 is considered more accurate, data at the inpatient unit level needed for Method 1 are not available. They begin looking at how length of stay is measured and why it is important. Length of stay (LOS) has been suggested as a meaningful outcome measure that is a potential target for quality improvement activities. 238, pp. The Importance of Length of Stay in Hospitals. Outcomes from these studies do suggest that a planned short-stay policy does not encourage a 'revolving door' pattern of admission and disjointed care for people with serious mental illness. Hospital length of stay (LOS) has long been a crucial barometer of hospital efficiency and quality of care. Clear discharge planning should start at the beginning of the admission and involve the interdisciplinary team to align with the needs of the patient. One of the things that the ACA did was change the way hospitals and other healthcare organizations are reimbursed. Sober Living Homes: A Way to Extend Addiction Treatment Length of Stay. Why is this metric important? The length of stay and discharge days is an important indicator of the efficiency of hospital management. What is this metric? For this project, I chose to focus on a more logistical metric of healthcare, hospital length-of-stay(LOS). The very low variation among hospitalists in 30-day readmission rates suggests that hospitalists are not important contributors to variations in those rates among hospitals. Looking beyond the returns of the patient’s experience by communicating length of stay, communicating and improving the patient length of stay has shown to improve patient preparedness. Average length of stay in hospitals. U.S. hospital stays cost the health system at least $377.5 billion per year. Did you know… We have over 220 college A decrease in hospital costs/ charges was also observed, ranging from WMD +261 US$ favouring usual care to WMD -4919 US$ favouring clinical pathways (in US$ dollar standardized to the year 2000). Anyone can earn Contact us today. Length of stay was the most commonly employed outcome measure with most studies reporting significant reductions. It comes down to realizing that hospital care usually costs more for patients and the organization than care in outpatient settings. Share of homeless in shelters and transitional housing by length of stay U.S. 2017 Turnover rate of emergency shelters and transitional housing in the U.S. 2007-2017 The most important statistics This finding is important because strategies aimed at patients who are frequently admitted may not be effective for those who generate the highest costs. To unlock this lesson you must be a Study.com Member. This metric measures the satisfaction level of a patient’s hospital stay and care … Improving this process may also have financial returns to the hospital by efficiencies gained and through a reduction of avoidable days. It comes down to realizing that hospital care usually costs more for patients and the organization than care in outpatient settings. All rights reserved. WHY LENGTH OF STAY MATTERS. From the viewpoint of a company’s policies on employment and turnover, the reasons why people stay in their jobs are just as important as the reasons why they leave them. Patient Satisfaction. Interactive solutions can assist in this process by engaging patients early in the care process and better preparing them for their role with discharge preparedness, so they are able to discharge when the discharge time has been determined. Our aim was to study variables associated with high LOS outliers and their evolution over time.