Impact of geographic localization on hospital length of stay: Evidence of a dose–response relationship

BACKGROUND: Geographic localization of patients and clinicians is a common approach to improve teamwork and efficiency, reduce hospital length of stay (LOS), and improve patient experience. We implemented a multidisciplinary initiative, called Patient-Centered Teams (PaCT), which reengineered bed management procedures and localized several hospital medicine teams to specific nursing units. OBJECTIVE: To evaluate the impact of PaCT on LOS and whether hospital units with a greater increase in localization experienced more LOS reduction. METHODS: Observational study of patients hospitalized at a large academic medical center between July 1, 2023 and February 26, 2025. Patients discharged from five hospital units that implemented geographic localization in September 2024 were included (N = 5868). Log-linear models quantified the impact of localization on hospital LOS overall and for each hospital unit separately, pre- versus postintervention, while adjusting for case mix index. Degree of localization was quantified as the percentage of patients discharged from the unit who were under the care of the main hospitalist team(s) assigned to that unit. RESULTS: Overall, a 10% reduction in LOS was observed following the localization initiative. In the two units which experienced the greatest increase in localization, LOS decreased by 13%-19%. In contrast, in two units which saw less of an increase in localization with this initiative, LOS did not significantly change in the postimplementation period. CONCLUSIONS: Implementing the PaCT geographic localization intervention was associated with shorter LOS, particularly among hospital units with the greatest increase in localization from baseline.