Objective: Monitoring length of stay (LOS) can help medical decision makers identify areas of potential improvements and improve resource management, which results in better quality of care for patients. This study aims to monitor process performance at hospitals by implementing a statistical process control (SPC) approach on LOS.Methods: The study focuses on diabetic inpatients admitted to hospitals in two national healthcare systems. The data used in this study were collected from two hospitals: (1) a 500-bed teaching hospital in Southwest Virginia in the U.S., and (2) a 1100-bed teaching and research hospital located in Ankara, Turkey. I-MR charts were used to analyze the datasets and monitor the variations of LOS.Results: The results of I-MR charts showed that LOS was longer in Turkey than the U.S. LOS was skewed toward minimum values in the U.S. whereas it was spread out in Turkey. The average LOS was 3.27 days (STD = 2.30) in the U.S. while it was 7.28 days (STD = 4.56) in Turkey. The differences in two national healthcare systems may be reflected in the LOS variable.Conclusion: This study implements a control chart-based approach to monitor LOS and detect prolonged hospitalization for diabetic patients. As presented in I-MR charts, there are abnormal LOS observations in each data set. The decision makers and caregivers must analyze I-MR charts to identify either common or special causes of variation. Each abnormal LOS requires a detailed patient-centric analysis. Care providers and decision makers can investigate the root causes of abnormal LOS for each patient by further exploring the characteristics of diabetic patients who had abnormal LOS at hospitals, such as age, preexisting conditions, or the type of medical procedure conducted on each patient.
Keywords: Hospital Length of Stay (LOS); I-MR charts; control charts; diabetes; quality; quality improvement in healthcare.