Case Study

Gundersen Heath System saved $1,600 per case by:

• Reducing Average Length of Stay: 1 day

• Increasing Physical Therapy on Day of Surgery to: 2/3 patients

• Reducing Usage of Skilled Nursing Facilities:  22%

With Avant-garde Health’s analytics, we’ve gained deep insights into performance across specialty areas, which helps us identify new opportunities to improve the delivery of care to our patients.
— Lisa Wied, VP, Gundersen Health

The Challenge

Already a cost-conscious, top performing organization and highly-rated by U.S. News & World Report, Gundersen Health System needed more advanced analytics to further its improvement efforts. Leaders sought a tool to help identify and support unseen opportunities for improvement across the care continuum in cardiology and cardiac surgery, neurosurgery, and orthopedics divisions.


The Solution

Avant-garde Health’s performance improvement analytics for both inpatient and post-acute care in orthopedics revealed several opportunities. According to benchmarks, personnel costs could be reduced with shorter lengths of stay (LOS) and to achieve more timely discharges, leaders focused on increasing physical therapy (PT) on day of surgery.  Also, to reduce post-acute care costs, leaders reduced spending on skilled nursing facilities (SNF).


The Plan 

Driven by these goals, Gundersen Health incorporated new protocols to make sure all stakeholders were better aligned. The action plan included:

  • Systematically sharing analytics with team members at all levels on a regular basis.
  • A multi-disciplinary team across the care continuum collaborates to optimize care pathways and increase standardization.
  • Requiring  patient and caregiver education 2-4 weeks prior and advance communication of discharge plan.


The Results

$1,600K Cost Savings Per Case Across the Continuum of Care


Reduced Length of Stay by One Day

Already performing better than national averages for length of stay (LOS), Gundersen reduced LOS by 20% in one year and by a full day in 18 months. The greatest |improvement in year one was the % of discharges between 1 to <2 days (2% to 14%).

Increased Physical Therapy on Day of Surgery to 68%

To drive down LOS, Gunderson targeted and tracked physical therapy (PT) on the day of surgery, which had not been standardized. After one year of effort, this metric improved to 23% and before 18 months it reached 68%.

Increased Discharge to Home, Reduced Use of SNFs

Gundersen decreased discharges to high-cost post-acute care (PAC) settings. An increase in discharges to home (65% to 78%) reduced usage of skilled nursing facilities (SNF), which resulted in reduced PAC costs.