If you had to pick a single metric to a measure a hospital, which would you choose?

Of course, you can’t boil everything about a hospital down to one, single data point. Defining quality, throughput, and other factors used to evaluate a hospital is difficult business. The Centers of Medicare & Medicaid Services (CMS) tracks dozens of core metrics related to both quality and process, both inpatients and outpatients. As a practicing ER doc, much of what I can do to improve outcomes for my patients comes down to delivering care more quickly, so it’s worth noting just how many of the CMS metrics relate to one thing: time.

The CMS website lists 36 different metrics under the category of “Timely and Effective Care,” most of which come down to providing a certain standard of care within a given time frame. Hospitals, while increasingly focused on the quality outcomes being measured by CMS, nonetheless often have a laser focus on various throughput measures, since a hospital’s ability to move volume through its facilities goes straight to the bottom line.

For hospital leaders it often comes down to a simple formula: X number of beds in the hospital, times 24 hours in a day, equals the amount of care the hospital is capable of delivering, and thus, billing for.

So while hospitals are enormous institutions with thousands of moving parts and dozens of interrelated services, sub-contractors, and physician groups all responsible for delivering on their piece of the healthcare puzzle, there is one metric that can encapsulate much of what works and what doesn’t in a hospital: emergency department length of stay for admitted patients.

It may seem counterintuitive, but measuring the length of stay in the emergency department for patients who are ultimately admitted actually provides an enormous window into a huge range of inpatient hospital processes.

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