A US Veterans Affairs hospital opened a short-stay rehabilitation unit within its community living centre in July 2023, led by hospitalists. The report tracked mean referral-to-discharge time, excluding periods when a referral was on hold. It fell from 6.89 days in fiscal year 2023 to 4.58 days in 2024 and 3.35 days in 2025.
The unit became the post-acute destination with the lowest delay and the most frequently used single rehabilitation destination at that facility. The authors suggest that bringing hospitalists into post-acute care may improve hospital throughput without adding post-acute beds.
This is a single-site description, before and after, with no comparison group, and the abstract does not report patient outcomes such as readmission, function or mortality. The setting is an integrated system with its own post-acute facility, which many hospitals do not have. It is a model to think about rather than evidence that it will transfer.
- Map where patients wait in your hospital for rehabilitation or step-down placement.
- Track referral-to-discharge time separately from hold periods to see the true delay.
- Involve physicians in post-acute decision-making rather than treating placement as a separate process.
- Look at readmission and functional outcomes as well as length of stay before copying the model.
Why it matters
It points at the wait for placement, not the clinical care, as a modifiable cause of long inpatient stays.
Don't overread it
This is a single-site description without a comparison group or patient outcomes; it does not show the model works elsewhere.
The statistics, in plain English
The fall from 6.89 to 3.35 days is a before-and-after comparison within one hospital. Without a control group, other changes over the same period (staffing, patient mix, other policies) could explain part of it.
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