A single Veterans Affairs hospital opened a short-stay rehabilitation unit run by hospitalists in July 2023. Patients needing post-acute rehabilitation often wait in acute beds for skilled nursing placement, so the unit aimed to shorten that wait.
Mean time from referral to discharge, excluding periods when referrals were on hold, fell from 6.89 days in fiscal year 2023 to 4.58 in 2024 and 3.35 in 2025. The unit became the destination with the lowest delay and the facility's most used rehabilitation destination.
This is an uncontrolled before-and-after description from one system. It does not report patient outcomes such as function, readmission or mortality, and it may not transfer to settings with different post-acute structures.
- Measure referral-to-discharge delay for post-acute placement in your own hospital
- Consider whether physician presence in a step-down unit could shorten waits
- Track function and readmissions as well as length of stay
- Be cautious about copying a model built in an integrated health system
Why it matters
Delays awaiting placement tie up acute beds, and this shows one way a hospital medicine team altered the pathway.
Don't overread it
It is a single-site service report with no patient outcomes or control group.
The statistics, in plain English
A before-and-after comparison can reflect changes that happened over the same period for other reasons, such as staffing or demand. There is no control group and no test of statistical significance in the report.
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