As with most industries, there are Major Issues in Healthcare. These issues span across different areas and they affect many organizations in the industry. Some of the major issues in healthcare are high rates of readmission and long length of stays in the hospitals. Long length of stays leads to congested hospitals and hospitals being full past capacity. When a hospital is congested, doctors and nurses struggle to deliver the best care. Reducing the length of stay means a reduction in bed occupancy which improves flow through the hospital system and also improves the working and caregiving environment. A reduction in crowding also means that patients are more likely to be treated on time and doctors and nurses can spend more time with their patients and understand their needs better.


Reduced length of stay in a hospital also means that there will be a reduced risk of harm and accidents which leads to a higher cost of care. The problem with long stays in the hospitals is that it leads to a ripple effect of negative outcomes that lead to the slow but deadly deterioration of a hospital and the quality of care they give. High length of stay is a major issue in healthcare because this long length of stays can be more deadly for certain patients and could have adverse effects and negative outcomes that are more deadly or more costly to treat than the initial illness that brought the patient to the hospital.


Adverse Effects of High Lenght of Stays


  • When a patient stays in the hospital for more than 10 days it can lead to up to 10 years of muscle aging. Some patients are at a higher risk of this than others.
  • Older patients experience decline after they have been admitted for a long period of time. This rate of decline increases at a faster rate the older the patient is. For patients, over 90 years they can decline at a 65% rate.
  • A lot of hospital bed admissions can be avoided as these patients could be attended to and their medical needs met at other points in a hospital and at a lower level of care with fewer uses of hospital accessories.
  • A lot of patients who have delayed discharges could have been discharged earlier using fewer resources and still have their needs met in a timely and quality fashion. Usually a lot of patients who are not discharged in time are not at fault but instead, the hospital could have discharged them if only they had proper and more effective systems in place. Ineffective internal management and redundant process flow and work systems lead to delays in discharging patients amongst other things.
  • Sometimes patients prefer to stay longer than necessary or longer than needed in a hospital because they have fear or anxiety about their illness and they think being discharged could mean deterioration of their health

Measures Put in Place to Reduce Lenght of Stay in Hospitals


There are software and established systems in place that healthcare organizations can either adapt or purchase to help them manage their admission and discharge flow more effectively. There are options and process that can put at the emergency departments, primary care departments, and other pathways that can help streamline the process.


Before a healthcare organization adopts any of these measures and changes, it is wise to first have a review process in place. This review can be done by an external service or a healthcare organization can appoint an in-house review team made up of both senior and mid-level management and staff members. When choosing a review team, it is important that the team members appropriately and accurately represent the healthcare organization.


There should be representatives from each key department and they must present the interests of their departments to the group. A team set up for these purposes should include medical research consultants, senior nurses, acute medical consultants, physician assistants, a general practitioner with good local knowledge, community representatives, the ambulance service and paramedics , integrated discharge team members, and representatives from social services, the voluntary sector, the independent sector, representatives from each department, and clinical commissioning group.


This team structure can be adjusted depending on the size of the organization and depending on the structure, location, specialty etc. For example, a healthcare facility that focuses on rehabilitation or heart surgeries or teaching hospitals is bound to have slightly different team structures that represent more accurately the type of organization and their goals. And before you think that the list is exhaustive, keep in mind that the point of putting together a team like this is to have whole system integration which will help tackle the issue of long length of stays more effectively.


The review group or external audit team should then submit report findings as well as recommendations on how to reduce inappropriate admissions or long length of stays of those that are admitted. The effectiveness of the report and its implementation could lead to swift improvements in a short period of time.


This kind of audit done by an internal team works best when there is a system-wide multidisciplinary representation and collaboration with external experts on the issue. The solutions should also inform wider and bigger plans to improve the quality of care across the healthcare organization.


The process of implementing plans to reduce the length of stays should be straightforward and should not contain complicated and hard to understand processes or recommendations. It should have a short-term plan (weeks or a couple of months) after which results should start to show.

Conclusion on Major Issues in Healthcare


 Inasmuch as long length of stay is a major issue in healthcare, hospitals should be watchful not to discharge patients before they are ready or before due diligence. A lot of times further monitoring could be what makes the difference between full recovery or life and death for a patient.