Reducing in-patient length of stay

Some time ago Kay Vaughn and colleagues working at the Colorado Psychiatric Hospital wrote a paper describing and evaluating the introduction of an alternative care regime in their part of the hospital, central to which was the integration of a solution focused approach to their work. On evaluating the new program they discovered a marked drop in average in-patient stay, from 20.2 days prior to the reorganisation to 6.6 days after it. This was achieved with no statistically significant increase in re-admissions. The decrease for those admitted in relation to eating and anxiety was even larger than this overall decrease.

It was interesting recently therefore to come across a reference to a London in-patient service working with children and young people reporting a similar change. A report dated 2007 states:
“Over the last three years the New Beginning Young People’s Crisis Recovery Unit in conjunction with local community adolescent services has successfully reduced average lengths of stay from an average of 72 days to 29 days against a target of 42 days. This has been achieved in partnership with young people in agreeing a strategy of focusing on the most important changes that need to happen to enable the young person to return to the community. This solution-focused approach has required increased input at a community level. It is hoped that in conjunction with commissioning partnerships, the savings freed up by this approach can be reinvested in further developing intensive therapeutic services in the community which can support discharge and prevent further readmission.“
We would be interested to know whether others have come across similar examples of the solution focused approach reducing in-patient lengths of stay.

Vaughn K, Young BC, Webster DC, Thomas MR A continuum-of-care model for inpatient psychiatric treatment. In Miller SD, Hubble MA, Duncan BL (eds) (1996) Handbook of Solution-Focused Brief Therapy. Jossey-Bass: San Francisco (p99-127).