Length of Stay
Prevent Excess Days & Discharge Delays with SIBR® Rounds
Length of Stay
Prevent Excess Days & Discharge Delays with SIBR® Rounds
Length of Stay
Prevent Excess Days & Discharge Delays with SIBR® Rounds
Shorten ALOS up to 0.5 days with SIBR rounds
SIBR Rounds are the ideal program to reduce LOS on your inpatient-units. Evidence-based, high-value, and designed by physicians and nurses just like you. We implement, you get the glory.
Finally a throughput initiative that isn’t a huge pain.
What is SIBR? (pronounced "cyber")
Structured Interdisciplinary Bedside Rounds
Research-backed, efficient, patient-centered team rounds
A 6-step communication protocol to create a shared mental model of who says what, when, and in what sequence
Brings the Bedside Nurse, Physician, & Allied Health to the patient's bedside to…
Synthesize mutually supported plans of care and discharge.
What is SIBR? (pronounced "cyber")
Structured Interdisciplinary Bedside Rounds
Research-backed, efficient, patient-centered team rounds
A 6-step communication protocol to create a shared mental model of who says what, when, and in what sequence
Brings the Bedside Nurse, Physician, & Allied Health to the patient's bedside to…
Synthesize mutually supported plans of care and discharge.
What is SIBR? (pronounced "cyber")
Structured Interdisciplinary Bedside Rounds
Research-backed, efficient, patient-centered team rounds
A 6-step communication protocol to create a shared mental model of who says what, when, and in what sequence
Brings the Bedside Nurse, Physician, & Allied Health to the patient's bedside to…
Synthesize mutually supported plans of care and discharge.
"We need to prevent
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
"We need to prevent
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
"We need to prevent
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
discharge delays"
excess days"
readmissions"
miscommunication"
adverse events"
Reported Excess Day Reductions
15%
Average Length of Stay reduction
1.3 days
Average Length of Stay reduction
Length of Stay initiatives are just agony for everybody. So to have a major LOS initiative made much easier, where a lot of the work is done – that’s what I liked.
Barbara Jacobs
CNO (retired)
"Quality improved while reducing costs by about $1,500 - $2,000 per patient per stay before versus after [implementing SIBR], and it also improved the same when we compared to a control group across the city."
Dr. John Manheim
Unit Medical Leader
Two and a half months ago we implemented our first Accountable Care Unit… So far, this system has had a very positive impact on patient care. On average patients on this unit are heading home a half day earlier.
John Ash
Director of Patient Flow, Canada
Our research found through a Difference-in-Differences analysis that our ACUs have had on average 0.679 fewer excess days per patient discharge over the past two years since implementation.
Zach Sheff PhD
Health Services Researcher
Less time in the hospital, the freeing up of beds. The care is better. The communication is better.
Health Region Executive
Canada
Length of Stay initiatives are just agony for everybody. So to have a major LOS initiative made much easier, where a lot of the work is done – that’s what I liked.
Barbara Jacobs
CNO (retired)
"Quality improved while reducing costs by about $1,500 - $2,000 per patient per stay before versus after [implementing SIBR], and it also improved the same when we compared to a control group across the city."
Dr. John Manheim
Unit Medical Leader
Two and a half months ago we implemented our first Accountable Care Unit… So far, this system has had a very positive impact on patient care. On average patients on this unit are heading home a half day earlier.
John Ash
Director of Patient Flow, Canada
Our research found through a Difference-in-Differences analysis that our ACUs have had on average 0.679 fewer excess days per patient discharge over the past two years since implementation.
Zach Sheff PhD
Health Services Researcher
Less time in the hospital, the freeing up of beds. The care is better. The communication is better.
Health Region Executive
Canada
Length of Stay initiatives are just agony for everybody. So to have a major LOS initiative made much easier, where a lot of the work is done – that’s what I liked.
Barbara Jacobs
CNO (retired)
"Quality improved while reducing costs by about $1,500 - $2,000 per patient per stay before versus after [implementing SIBR], and it also improved the same when we compared to a control group across the city."
Dr. John Manheim
Unit Medical Leader
Two and a half months ago we implemented our first Accountable Care Unit… So far, this system has had a very positive impact on patient care. On average patients on this unit are heading home a half day earlier.
John Ash
Director of Patient Flow, Canada
Our research found through a Difference-in-Differences analysis that our ACUs have had on average 0.679 fewer excess days per patient discharge over the past two years since implementation.
Zach Sheff PhD
Health Services Researcher
Less time in the hospital, the freeing up of beds. The care is better. The communication is better.
Health Region Executive
Canada
Features
SIBR Shortens Length of Stay Because it Hardwires the Ideal Discharge Huddle
1
Every patient, every morning
Hardwire into the morning workflow, no matter who the physician is
2
Includes the whole care team
Convene the hospitalist, bedside nurse, care manager, pharmacist
3
Structured and standardized
Discharge barriers, pre-admission details, needs & complex supports, & next site
4
Everyone comes prepared
Routines, training, and preparation ensure it's a good use of time for all
5
Doesn't exclude bedside nurse
Avoid discharge delays from common issues like mobility and delayed BMs
6
Synchronized and focused
Physician synthesizes a plan for discharge, including an EDD so everyone else can plan
Features
SIBR Shortens Length of Stay Because it Hardwires the Ideal Discharge Huddle
1
Every patient, every morning
Hardwire into the morning workflow, no matter who the physician is
2
Includes the whole care team
Convene the hospitalist, bedside nurse, care manager, pharmacist
3
Structured and standardized
Discharge barriers, pre-admission details, needs & complex supports, & next site
4
Everyone comes prepared
Routines, training, and preparation ensure it's a good use of time for all
5
Doesn't exclude bedside nurse
Avoid discharge delays from common issues like mobility and delayed BMs
6
Synchronized and focused
Physician synthesizes a plan for discharge, including an EDD so everyone else can plan
Features
SIBR Shortens Length of Stay Because it Hardwires the Ideal Discharge Huddle
1
Every patient, every morning
Hardwire into the morning workflow, no matter who the physician is
2
Includes the whole care team
Convene the hospitalist, bedside nurse, care manager, pharmacist
3
Structured and standardized
Discharge barriers, pre-admission details, needs & complex supports, & next site
4
Everyone comes prepared
Routines, training, and preparation ensure it's a good use of time for all
5
Doesn't exclude bedside nurse
Avoid discharge delays from common issues like mobility and delayed BMs
6
Synchronized and focused
Physician synthesizes a plan for discharge, including an EDD so everyone else can plan
"How is SIBR different than our current interdisciplinary rounds?"
Compare Structured Interdisciplinary Bedside Rounds with other common types of multidisciplinary rounding
Unit-Oriented Doctors
"Run the list" huddles
Traditional Rounds
SIBR rounds
Who?
Hospitalist, Care Manager, & Charge Nurse
Hospitalist & Bedside Nurse
Entire care team: Hospitalist, Bedside Nurse, Care Manager, Pharmacist, managed by Charge Nurse
Where?
Nurses’ Station or Conference Room
Bedside or Conference Room
Bedside
Consistent start and end times
✔
?
✔
Average duration
1-2 mins per patient
5-15 minutes per patient
3-5 minutes per patient
7-days a week
⤬
⤬
✔
Quality-Safety
Quality-Safety Checklist reviewed with Bedside Nurse
⤬
⤬
✔
Bedside Nurse concerns addressed
⤬
?
✔
Pharmacist discusses medication safety
⤬
?
✔
Standardized, structured communication protocol
⤬
⤬
✔
Collaborative Cross-Checking
⤬
?
✔
Discharge Coordination
Mobility & last BM
?
?
✔
EDD each day for each patient
?
⤬
✔
Interdisciplinary discharge plan
✔
⤬
✔
Shorter length of stay
?
⤬
✔
Patient & Family Centered
Involves patient
⤬
⤬
✔
Patient’s Goal for the Day
⤬
⤬
✔
Common questions answered proactively
⤬
⤬
✔
Family knows when to join & invited
⤬
⤬
✔
Higher patient satisfaction scores
⤬
⤬
✔
Nursing Involvement
Interdisciplinary care plan
⤬
?
✔
Supports inexperienced nurses
⤬
⤬
✔
Nurses not in rounds all morning
N/A
?
✔
Continuous Quality Improvement
Skills Certification based on High-Performance Behaviors
⤬
⤬
✔
Daily rounds data feeding leadership dashboards and alerts
⤬
⤬
✔
Supports Resilience and High Reliability Organization (HRO) goals
⤬
⤬
✔
Evidence and Credibility
Award-winning care model
⤬
⤬
✔
Well-supported in the literature
⤬
⤬
✔
Summary
Advantages
Brief, Discharge-oriented
Adjusts to physician preferences
Patient-centered, timely, efficient, proactive, clear plan of care and for discharge
Disadvantages
No interdisciplinary care planning
No patient/family presence
Requires experts to help implement and hardwire
"How is SIBR different than our current interdisciplinary rounds?"
Compare Structured Interdisciplinary Bedside Rounds with other common types of multidisciplinary rounding
"Run the list" huddles
Conference room medical rounds
Traditional Rounds
SIBR rounds
Who?
Hospitalist, Care Manager, & Charge Nurse
Hospitalist, Care Manager, & Charge Nurse
Hospitalist & Bedside Nurse
Entire care team: Hospitalist, Bedside Nurse, Care Manager, Pharmacist, managed by Charge Nurse
Where?
Nurses’ Station or Conference Room
Conference Room
Bedside
Bedside
Consistent start and end times
✔
✔
X
✔
Average duration
1-2 mins per patient
2-3 minutes per patient
5-15 minutes per patient
3-5 minutes per patient
7-days a week
⤬
⤬
✔
✔
Quality-Safety
Quality-Safety Checklist reviewed with Bedside Nurse
⤬
⤬
⤬
✔
Bedside Nurse concerns addressed
⤬
⤬
?
✔
Pharmacist discusses medication safety
⤬
✔
?
✔
Standardized, structured communication protocol
⤬
?
⤬
✔
Collaborative Cross-Checking
⤬
?
?
✔
Discharge Coordination
Mobility & last BM
?
?
?
✔
Collaborative Cross-Checking
⤬
?
?
✔
Patient & Family Centered
EDD each day for each patient
?
?
⤬
✔
Interdisciplinary discharge plan
✔
✔
⤬
✔
Shorter Length of Stay
?
⤬
⤬
✔
Nursing Involvement
Involves patient
⤬
⤬
⤬
✔
Patient’s Goal for the Day
⤬
⤬
⤬
✔
Common questions answered proactively
⤬
⤬
⤬
✔
Family knows when to join & invited
⤬
⤬
⤬
✔
Higher patient satisfaction scores
⤬
⤬
⤬
✔
Interdisciplinary care plan
⤬
⤬
✔
✔
Supports inexperienced nurses
⤬
⤬
⤬
✔
Nurses not in rounds all morning
N/A
N/A
⤬
✔
Continuous Quality Improvement
Skills Certification based on High-Performance Behaviors
⤬
⤬
⤬
✔
Daily rounds data feeding leadership dashboards and alerts
⤬
⤬
⤬
✔
Supports Resilience and High Reliability Organization (HRO) goals
⤬
⤬
⤬
✔
Evidence and Credibility
Award-winning care model
⤬
⤬
⤬
✔
Well-supported in the literature
⤬
⤬
⤬
✔
Summary
What works?
Brief
Discharge oriented
Adjusts to physician preferences
Patient-centered, timely, efficient, proactive, clear plan of care and for discharge
What's missing?
No interdisciplinary care planning
No patient/family presence
Primary data gathering happens together
Requires experts to implement and sustain
"How is SIBR different than our current interdisciplinary rounds?"
Compare Structured Interdisciplinary Bedside Rounds with other common types of multidisciplinary rounding
Unit-Oriented Doctors
"Run the list" huddles
Traditional Rounds
SIBR rounds
Who?
Hospitalist, Care Manager, & Charge Nurse
Hospitalist & Bedside Nurse
Entire care team: Hospitalist, Bedside Nurse, Care Manager, Pharmacist, managed by Charge Nurse
Where?
Nurses’ Station or Conference Room
Bedside or Conference Room
Bedside
Consistent start and end times
✔
?
✔
Average duration
1-2 mins per patient
5-15 minutes per patient
3-5 minutes per patient
7-days a week
⤬
⤬
✔
Quality-Safety
Quality-Safety Checklist reviewed with Bedside Nurse
⤬
⤬
✔
Bedside Nurse concerns addressed
⤬
?
✔
Pharmacist discusses medication safety
⤬
?
✔
Standardized, structured communication protocol
⤬
⤬
✔
Collaborative Cross-Checking
⤬
?
✔
Discharge Coordination
Mobility & last BM
?
?
✔
EDD each day for each patient
?
⤬
✔
Interdisciplinary discharge plan
✔
⤬
✔
Shorter length of stay
?
⤬
✔
Patient & Family Centered
Involves patient
⤬
⤬
✔
Patient’s Goal for the Day
⤬
⤬
✔
Common questions answered proactively
⤬
⤬
✔
Family knows when to join & invited
⤬
⤬
✔
Higher patient satisfaction scores
⤬
⤬
✔
Nursing Involvement
Interdisciplinary care plan
⤬
?
✔
Supports inexperienced nurses
⤬
⤬
✔
Nurses not in rounds all morning
N/A
?
✔
Continuous Quality Improvement
Skills Certification based on High-Performance Behaviors
⤬
⤬
✔
Daily rounds data feeding leadership dashboards and alerts
⤬
⤬
✔
Supports Resilience and High Reliability Organization (HRO) goals
⤬
⤬
✔
Evidence and Credibility
Award-winning care model
⤬
⤬
✔
Well-supported in the literature
⤬
⤬
✔
Summary
Advantages
Brief, Discharge-oriented
Adjusts to physician preferences
Patient-centered, timely, efficient, proactive, clear plan of care and for discharge
Disadvantages
No interdisciplinary care planning
No patient/family presence
Requires experts to help implement and hardwire
Typical Impact on Readmissions
Along with improvements in length-of-stay, several hospitals have reported reductions in 7-, 28- and 30-readmissions, achieved through:
Unit-Oriented Doctors
Improved communication and awareness of post-discharge needs
Proactive discharge planning
Proactive identification and addressing of readmission risk factors
Recognize and mitigate
Early recognition and management of clinical deterioration
Patient & family engagement
Enhanced patient and family understanding
Reported Readmission Rate Reductions
20%
Average Readmission Rate reduction
Typical Impact on Readmissions
Along with improvements in length-of-stay, several hospitals have reported reductions in 7-, 28- and 30-readmissions, achieved through:
Unit-Oriented Doctors
Improved communication and awareness of post-discharge needs
Proactive discharge planning
Proactive identification and addressing of readmission risk factors
Recognize and mitigate
Early recognition and management of clinical deterioration
Patient & family engagement
Enhanced patient and family understanding
Reported Readmission Rate Reductions
20%
Average Readmission Rate reduction
Typical Impact on Readmissions
Along with improvements in length-of-stay, several hospitals have reported reductions in 7-, 28- and 30-readmissions, achieved through:
Unit-Oriented Doctors
Improved communication and awareness of post-discharge needs
Proactive discharge planning
Proactive identification and addressing of readmission risk factors
Recognize and mitigate
Early recognition and management of clinical deterioration
Patient & family engagement
Enhanced patient and family understanding
Reported Readmission Rate Reductions
20%
Average Readmission Rate reduction
Typical Impact on Cost Savings
Improvements in length-of-stay and readmission rates have significantly reduced several hospitals cost of care, achieved through:
Unit-Oriented Doctors
Reductions in labs, tests, medications etc.
Indirect care costs
Reductions in nursing overtime, sick pay and recruitment
HACs & HAIs
Reductions in hospital acquired conditions and infections
Reported Cost of Care Reductions
$1M
Average cost of care reduction
34-71%
Average nursing overtime reduction
Typical Impact on Cost Savings
Improvements in length-of-stay and readmission rates have significantly reduced several hospitals cost of care, achieved through:
Unit-Oriented Doctors
Reductions in labs, tests, medications etc.
Indirect care costs
Reductions in nursing overtime, sick pay and recruitment
HACs & HAIs
Reductions in hospital acquired conditions and infections
Reported Cost of Care Reductions
$1M
Average cost of care reduction
34-71%
Average nursing overtime reduction
Typical Impact on Cost Savings
Improvements in length-of-stay and readmission rates have significantly reduced several hospitals cost of care, achieved through:
Unit-Oriented Doctors
Reductions in labs, tests, medications etc.
Indirect care costs
Reductions in nursing overtime, sick pay and recruitment
HACs & HAIs
Reductions in hospital acquired conditions and infections
Reported Cost of Care Reductions
$1M
Average cost of care reduction
34-71%
Average nursing overtime reduction
Top Case Studies
Emory Healthcare
10% Reduction in Length of Stay
Stein, J., Payne, C., Methvin, A., Bonsall, J.M., Chadwick, L., Clark, D., Castle, B.W., Tong, D. & Dressler, D.D.
Journal of Hospital Medicine
The Christ Hospital
11% lower LOS to home vs. control 28% lower LOS to SNF vs. control
Gausvik, C., Lautar, A., Goroncy, A. & Schlaudecker, J.
Journal of the American Geriatrics Society
Loma Linda University Children's Hospital
10% reduction in ICU length of stay
Merrick Lopez, Yana Vaks, Michele Wilson, Kenneth Mitchell, Christina Lee, Janeth Ejike, Grace Oei, Danny Kaufman, Jamie Hambly, Cynthia Tinsley, Thomas Bahk, Carlos Samayoa, James Pappas, Shamel Abd-Allah
Pediatric Quality & Safety
Top Case Studies
Emory Healthcare
10% Reduction in Length of Stay
Stein, J., Payne, C., Methvin, A., Bonsall, J.M., Chadwick, L., Clark, D., Castle, B.W., Tong, D. & Dressler, D.D.
Journal of Hospital Medicine
The Christ Hospital
11% lower LOS to home vs. control 28% lower LOS to SNF vs. control
Gausvik, C., Lautar, A., Goroncy, A. & Schlaudecker, J.
Journal of the American Geriatrics Society
Loma Linda University Children's Hospital
10% reduction in ICU length of stay
Merrick Lopez, Yana Vaks, Michele Wilson, Kenneth Mitchell, Christina Lee, Janeth Ejike, Grace Oei, Danny Kaufman, Jamie Hambly, Cynthia Tinsley, Thomas Bahk, Carlos Samayoa, James Pappas, Shamel Abd-Allah
Pediatric Quality & Safety
Top Case Studies
Emory Healthcare
10% Reduction in Length of Stay
Stein, J., Payne, C., Methvin, A., Bonsall, J.M., Chadwick, L., Clark, D., Castle, B.W., Tong, D. & Dressler, D.D.
Journal of Hospital Medicine
The Christ Hospital
11% lower LOS to home vs. control 28% lower LOS to SNF vs. control
Gausvik, C., Lautar, A., Goroncy, A. & Schlaudecker, J.
Journal of the American Geriatrics Society
Loma Linda University Children's Hospital
10% reduction in ICU length of stay
Merrick Lopez, Yana Vaks, Michele Wilson, Kenneth Mitchell, Christina Lee, Janeth Ejike, Grace Oei, Danny Kaufman, Jamie Hambly, Cynthia Tinsley, Thomas Bahk, Carlos Samayoa, James Pappas, Shamel Abd-Allah
Pediatric Quality & Safety
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