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Bringing Care Closer to Home by Decreasing Length of Stay, Readmissions, and ED Diversions

Monument Health—serving rural communities within 300 miles of Rapid City, South Dakota—leveraged technology and standardized processes to improve patient flow, reducing length of stay by 22% and readmissions by 10%.

Monument Health, headquartered in Rapid City, South Dakota, struggled with delayed discharges tying up beds and staff time, straining their capacity. As the leading healthcare system in a 300-mile radius throughout South Dakota and eastern Wyoming, patients rely on Monument Health for acute care—when it is unable to accept new patients due to limited capacity, patients may have to travel hundreds of miles from home. By creating a liaison role to improve communication between providers and case managers, establishing a culture of proactively preparing for discharges, and using Epic to add automation and transparency to patient flow, Monument Health lowered their average length of stay (LOS) by 22% from 2017 to 2019, from 6.02 to 4.68 days. It also lowered its 30-day readmission rate by 10% from 2018 to 2021, keeping more beds open for patients.

How They Did It:

  • Used analytics to identify sources of long lengths of stay
  • Established a liaison role between providers and unit case managers
  • Educated clinicians on how to best prepare patients for discharge
  • Used automation, bed planning, and patient lists to streamline patient flow

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