Improving Care for Longstayers
Care Continuum
Care Process & Redesign
National Healthcare Innovation and Productivity Medals
National Healthcare Group
27 January 2026
The aim was a 30% reduction in total bed-days of longstayers within the Medicine department by Dec 2022, leading to better. The interventions were successfully implemented and scaled up, becoming part of Business-as-Usual (BAU) operations within the hospital.
Year Submitted: 2025
Published Date: 27 January 2026
Tags: Workflow Redesign, Cost Effectiveness, Care Process ＆ Redesign, Time Saving, Quality Improvement, Productivity
About this Content
Aims
The aim was a 30% reduction in total bed-days of longstayers within the Medicine department by Dec 2022, leading to better patient outcomes, optimized bed occupancy rate (BOR), and reduced Average length of stay (ALOS) for the hospital.
Background
Prolonged hospital stays are associated with poorer hospital outcomes due to an increased risk of deconditioning and hospital-acquired infections. At the hospital, longstayers (LOS 21 days) were occupying 1 in 4 beds, with 74% under the care of the Medicine department.
Methods
A multi-disciplinary project team was set up in 2021 to redesign the care of longstayers and reduce unnecessary prolonged hospital stays. The team mapped the longstayers' patient journey and identified process gaps. Interventions included EDD documentation, a longstayers virtual ward, and multi-disciplinary meetings (MDM).
Results
Upon successful implementation of the interventions, total bed-days of patients in the longstayers ward were 34% lower compared to all other General Medicine (control) wards. 525 bed-days were saved each month as a result. Results continued to be sustained in the control phase in 2023.
Conclusion
The interventions were successfully implemented and scaled up, becoming part of Business-as-Usual (BAU) operations within the hospital.
Lessons Learnt
The success of the project was attributed to having a multi-disciplinary team who believed in the goal of the project. Team members were open and willing to share their thoughts, often challenging the status quo, which led to better solutions.
Keywords
Longstayers, Hospital, Bed Occupancy, Patient Outcomes, Multi-disciplinary
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | National Healthcare Group |
Platform(s) | National Healthcare Innovation and Productivity Medals |
Healthcare Professional Group(s) | Medical, Nursing, Healthcare Administration |
Applicable Specialty or Discipline | Healthcare Administrators |
Project Lead(s) | Norhisham Main |
Project Member(s) | PANG LU KIAT |
Connect with this contributor!
Norhisham Main - norhisham_main@nuhs.edu.sg