Virtual Multidisciplinary Rounds Help Cut Length of Patient Stay

August 25, 2023 - Virtual multidisciplinary rounds, combined with interventions like discharge huddles, can reduce patient length of stay (LOS) and observation hours, according to a new study.

Previous research, stretching back more than a decade, has shown a correlation between in-person multidisciplinary rounding and reduced patient LOS. For instance, a study published in 2007 revealed that instituting multidisciplinary rounds improved adjusted overall monthly performance rates and reduced adjusted average LOS by 0.5 days for patients with diagnoses of heart failure, pneumonia, or heart attack.

The new study published in the September issue of The Joint Commission Journal on Quality and Patient Safety aimed to assess the efficacy of multidisciplinary rounds conducted virtually in improving patient throughput.

Arizona-based Yuma Regional Medical Center researchers conducted the study. They designed and implemented virtual multidisciplinary rounds through conference calls with stakeholders in the facility, including hospitalists, case managers, nurse leaders, and the clinical documentation improvement team.

The researchers created dashboards to track patient progress in real time. Data for the dashboards were gathered from EHRs. A few months after the implementation of virtual multidisciplinary rounds, the research team helped establish unit-based discharge huddles to supplement the virtual rounds.

The study shows that more than 60 percent of discharges fell below geometric mean LOS after the initiative was implemented, compared to approximately 52 percent prior to implementation.

In addition, mean observation hours dropped from around 44 to 31.9 hours. The hospital was able to maintain this change for more than a year. Overall, 3,813 excess days were reduced in 10 months, resulting in combined savings of $6.7 million in fiscal year 2021, the study states.

The intervention also led to a decrease in variation among hospitalists providing care for patients.

Thus, researchers concluded that virtual multidisciplinary rounds not only helped reduce LOS and observation hours but also curbed hospitalist variation and improved stakeholder engagement within the hospital.

Direct-to-consumer telehealth soared during the COVID-19 pandemic, but amid this boom, healthcare provider organizations have continued to use virtual care modalities to connect clinicians in a bid to enhance care coordination and access to specialty care.

For instance, several Virginia-based healthcare groups announced earlier this year that they would establish a consortium to improve chronic disease management across the state.

Through the Virginia Consortium to Advance Health in Appalachia, the organizations aim to expand healthcare access using various virtual care services and technologies. Among multiple efforts, the consortium will expand interactive home monitoring services to track cardiovascular disease factors and expand two state-funded regional programs that provide virtual mental healthcare and chronic disease prevention and management services.

The consortium includes the UVA Center for Telehealth, the Healthy Appalachia Institute at the University of Virginia's College at Wise, and Ballad Health.

Similarly, to address the lack of neonatal intensive care access and provide higher-acuity care for newborns in New Mexico, San Juan Regional Medical Center struck a telehealth partnership with Presbyterian Hospital's neonatal intensive care unit (NICU) team in December 2022.

San Juan Regional deployed a telemedicine cart to facilitate virtual video consultations with Presbyterian's NICU team. According to Michael Rankin, MD, who heads up newborn transfer and is a neonatologist in Presbyterian Hospital's NICU, the telehealth partnership provides "a layer of patient care that wasn't there before."