By Gina Kidder, Clinical Outcomes Engineer, ABOUT Healthcare
LinkedIn: Gina Kidder
LinkedIn: ABOUT Healthcare
Minimizing length of stay (LOS) while at the same time maintaining high-quality patient care is a persistent and complex challenge for health systems that affects care quality, patient throughput, financial performance, and staff workload.
While many healthcare organizations launch large-scale, system-wide initiatives to address issues involving LOS, these efforts can often feel overwhelming and overlook one of the most impactful levers: case management.
When equipped with the right tools, real-time data, cross-functional alignment, and organizational empowerment, case management teams are uniquely positioned to streamline care transitions, reduce delays, and improve patient flow.
However, achieving this transformation sometimes requires a cultural shift across the organization. Hospitals must empower case managers to think critically, challenge norms, and act as patient advocates, not just referral processors. By elevating the visibility and influence of case management, hospitals and health systems can unlock measurable improvements from within their own organizations.
Technology’s role in reducing LOS
The average LOS in U.S. hospitals is about five days per patient. When patients stay in the hospital longer than necessary, excess days can bring a host of negative consequences for patients and hospitals. For example, patients who stay in the hospital longer than necessary are at a greater risk of experiencing hospital-acquired infections and falls, in addition to decreased patient satisfaction. For hospitals, excessive LOS can create rising costs, additional stress for staff members, and missed opportunities to improve patient flow.
To avoid problems associated with discharge planning that stretch patients’ LOS, many hospitals are investing in technology that goes far beyond traditional “fax and phone call” processes of making referrals to next sites of care. When done with the right solutions, technology can go beyond automation and deliver insights and intelligence into aligned decisioning across multi-disciplinary teams.
Case managers need solutions that integrate directly with electronic health records (EHRs), eliminate duplicative documentation, and surface real-time insights for the entire multidisciplinary care team. Without shared visibility into discharge milestones, patients often receive mixed messages about their care plan, a scenario that fuels confusion and delays. Technology should align all care team members on one version of the plan that details the patient’s estimated discharge date, what is needed to meet it, and who is responsible for each next step.
Purpose-built platforms can bring structure to multidisciplinary rounds, guide prioritization of tasks, and make discharge plans accessible and up-to-date. Additionally, they provide insights and dashboards that answer critical questions in real time: Has the home health referral gone through? Is transportation arranged? Have we received prior authorization? Technology must help surface the barriers to discharge early and make them actionable.
The goal is not to replace human judgment, but to amplify it. With the right data in hand, case managers can work at the top of their licenses, think critically, and influence care delivery in ways that result in safer, faster transitions for patients.
A new approach to case management
Reducing LOS begins with reframing case management from a task-based role to a strategic function facilitated by data, visibility, and influence. Hospitals can take the following steps to elevate their case management programs:
- Identify the discharge plan early in the stay: Discharge planning should begin at admission, not after. Early identification of a patient’s needs — clinical, financial, and social — can help avoid downstream delays. Case managers should assess discharge barriers and post-acute care needs on day one to guide care decisions throughout the stay.
- Develop data and insights into the post-acute network: Understanding how referral partners perform is essential. Hospitals should collect data on acceptance rates, response times, and length of prior authorization processes for each post-acute care provider. These insights can help shift more patients home, reduce wait times, and inform strategic partnerships with high-performing facilities.
- Reclaim the prior authorization process: Delays in prior authorization related to discharge often add avoidable days to hospital stays. Hospitals can gain control by bringing this process back in-house, rather than leaving it to receiving facilities. Case managers equipped with the right tools can initiate prior authorizations early and package them directly with referral documents, speeding up transitions.
- Perform data-driven next-site-of-care course corrections: Discharge decisions shouldn’t be locked in too early. Case managers must have the authority and data to pivot when circumstances change. For example, if a patient regains mobility faster than expected, the plan might shift from rehab to home health. Timely reassessment ensures patients aren’t waiting for unnecessary resources.
- Ensure visibility across the care team: Everyone involved in patient care, from nurses to physicians to social workers, should be working from the same care plan. Technology must centralize the discharge roadmap and make it accessible to all, ensuring consistent communication with the patient and family.
Unlocking case management’s full potential
Case management is a powerful, often underutilized lever for reducing length of stay. When hospitals invest in empowering their case managers — through technology, best practices, and cross-functional alignment — they gain a strategic asset capable of improving throughput, enhancing care quality, and reducing financial waste. Case managers uniquely bring clinical, social, and financial expertise to patient flow and care transitions. Additionally, real-time visibility, early discharge planning, and data-informed decisions allow care teams to address barriers before they become delays.
Ultimately, reducing LOS isn’t about pushing patients out faster. It’s about aligning everyone on the safest, most timely discharge path. With the right tools and mindset, case managers can lead this transformation — bringing together clinical expertise, reimbursement knowledge, and social insight to ensure every patient leaves the hospital at the right time, for the right reason, to the right next-site-of-care.