Significant reduction in length of stay and readmission rate over 3 years on an ACE unit optimized with daily SIBR

CE Gausvik, A Lautar, A Goroncy, J Schlaudecker
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Overview

In a study conducted by the University of Cincinnati College of Medicine, the implementation of daily Structured Interdisciplinary Bedside Rounds (SIBR) on an Acute Care for Elders (ACE) unit significantly reduced length of stay (LOS) and 30-day readmission rates.

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28% lower LOS to home vs. control
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28% lower LOS to SNF vs. control

Objectives

To assess the impact of implementing daily Structured Interdisciplinary Bedside Rounds (SIBR) on LOS and readmission rates in an ACE unit.

Methods

The study was conducted on a 10-bed ACE unit utilizing SIBR as a communication tool among the interdisciplinary team, which included a nurse practitioner (NP), social worker, therapist, nurse-aide, and geriatrician. The geriatrician was present for only 8 hours per week, optimizing cost savings. The study tracked LOS and 30-day readmission rates for three years, comparing the ACE unit’s outcomes with a similar control population not utilizing SIBR.

Results

Length of Stay (LOS):

• Patients returning home: 3.73 days vs. 4.21 days in control (P = 0.001)

• Patients discharged to SNF: 5.24 days vs. 7.26 days in control (P < 0.001)

30-Day Readmissions:

• Patients discharged to SNF: 11.68% vs. 14.70% in control (P < 0.05)

Conclusion

The implementation of daily Structured Interdisciplinary Bedside Rounds (SIBR) on the ACE unit significantly reduced both length of stay and 30-day readmission rates. These results highlight the effectiveness of SIBR in improving patient outcomes and optimizing team communication in a healthcare setting, particularly for older adults with frailty and chronic conditions.

I hope you enjoyed reading these strong results. Unit outcomes like these are achievable within 3 to 6 months using a seasoned implementation methodology:

  1. skillful project management
  2. smooth training and launch, and a
  3. long-term partnership for sustainability.

One option to achieve similar results is to engage our 1Unit experts. Backed by 15 studies like this one, our work has received awards from The Joint Commission, CMS, Clinical Excellence Commission, IHI, BMJ, and the Society of Hospital Medicine.

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Liam Chadwick, PhD