Dear Colleagues:
Over the coming months, there will be a focus on opportunities for Length of Stay (LOS) improvement in the areas of BWH facility-related delays, service-specific clinical management initiatives, and the Tower regionalization plan.

To better establish an acute rehabilitation continuum beyond the walls of BWH, relationships have been reinforced with the Youville Vent Unit, including an appointed BWH physician (Christopher Fanta, MD) as the director. Also, optional sites and programs continued to be evaluated. Likewise, much work has been done surrounding BWH’s relationship with skilled nursing facilities (SNFs). The Boston Center “Value Transfer” program has been a success and has grown to eight BWH-designated beds. With the help of this relationship and others, the average LOS for patients needing SNFs has decreased from 27 to 14 days. Similarly, targeted efforts with Partners Home Care involving orthopedic and thoracic patients; the execution of the 4-Next program; and the new Dana-Farber Cancer Institute-owned hospice program, will provide even more progress with LOS reduction. Also, a soon-to-be established Palliative Care Unit at BWH will address multiple patient needs, while at the same time helping to reduce LOS.

Finally, the restructuring of BWH’s clinical pathway program has incorporated many components including daily pathway forms and a “plan for the stay,” which highlights expected daily progression. To find out more about specific pathways in your discipline, contact your division chief or department chair.

A team effort remains pivotal to reaching our FY04 LOS goal of 5.55 days and we continue to encourage both intradepartmental and multidisciplinary effort to bring about the desired result.

Sincerely yours,


Lawrence H. Cohn, MD
Chairman, BWPO