scholarly journals Length of stay patterns for patients of an acute care hospital: implications for nutrition and food services

2007 ◽  
Vol 31 (2) ◽  
pp. 282 ◽  
Author(s):  
Angela P Vivanti ◽  
Merrilyn D Banks
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Average Length ◽  
Acute Care Hospital ◽  
Tertiary Hospital ◽  
Service Planning ◽  
Care Hospital ◽  
Large Patient ◽  
Increased Risk ◽  
Time Periods

Objective: Shortened hospital average length of stay (ALOS) has been used to justify rationalisation of some services, but, by definition, some patients stay for longer than the average. The objective of this study was to explore lengths of stay and proportions of hospital occupied bed-days (OBDs) of those admitted for longer time periods to inform service planning. Methods: The proportion and ALOS of overnight separations at an Australian tertiary hospital were assessed for admissions of up to 4 days and 4 days or more. This was repeated for 7, 14 and 28 days. The proportion of OBD?s for each time period was determined. Results: While the proportion of total hospital patients staying for 4, 7, 14 and 28 days or more is relatively small (21.9%, 13.5%, 6.2%, 2.6%, respectively), they represent a large proportion of OBD?s (74.9%, 67.2%, 50.8%, 34.2%) with an ALOS of 14.0, 20.3, 33.7, and 54.4 days, respectively. The majority of long-stay patients were in acute care. Conclusion: Substantial proportions of OBD?s are due to patients admitted for time periods far greater than reflected by ALOS. Hospitals need to rethink how to optimally accommodate the nutrition and food requirements of the large patient numbers admitted for longer time periods, many of whom are at increased risk of malnutrition.

scholarly journals The Implications of Long-Term Acute Care Hospital Transfer Practices for Measures of In-Hospital Mortality and Length of Stay

2012 ◽  
Vol 185 (1) ◽  
pp. 53-57 ◽  
Author(s):  
William B. Hall ◽  
Laura E. Willis ◽  
Sofia Medvedev ◽  
Shannon S. Carson
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Hospital Transfer

scholarly journals 1263. Managing an Influenza Outbreak Which Spilled Over to an Acute Care Hospital from a Behavioral Health Unit

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S385-S385
Author(s):  
Colleen M Clay ◽  
Leonardo Girio-Herrera ◽  
Faheem Younus
Keyword(s):  
Behavioral Health ◽  
Acute Care ◽  
Influenza A ◽  
Average Length ◽  
Acute Care Hospital ◽  
Control Measures ◽  
Care Hospital ◽  
Prevention Measures ◽  
Influenza Outbreak ◽  
Hospital Acquired

Abstract Background Behavioral health units (BHU) have been implicated in influenza outbreaks due to group activities, low availability of alcohol-based hand gels and unique host factors. We describe the management of an unusual influenza outbreak, which started in the BHU and then spilled over to the acute care hospital (ACH). Methods University of Maryland Harford Memorial Hospital is a 95-bed ACH with a 14-bed closed-door adult BHU located on the fifth floor. Two cases each of hospital-acquired influenza were identified in our BHU during 2016 and 2017. In January 2018, however, hospital-acquired influenza cases in the BHU spilled over to the adjacent ACH to cause an outbreak. A case was defined as a patient with fever of >100.4°F, presence of influenza-like illness, and a positive influenza test >72 hours after admission. Outbreak control measures included twice daily fever screening, enhanced droplet precautions, visitor restrictions, discontinuing community activities, enforcing hand hygiene at all hospital entrances, and hospital-wide chemoprophylaxis with oseltamivir. Results On January 15, 2018, the index patient developed influenza in the BHU followed by a second case in BHU 4-days later. Over the next 10 days, five more patients on the third and fourth floors of ACH tested positive. Attack rate was 3% and average length of stay was 8.9 days. Chemoprophylaxis with oseltamivir 75 mg orally once a day was given to 71% of all eligible hospitalized patients for a week (at a cost of $17,000). All seven patients yielded influenza A, subtype H3N2 and were successfully treated with oseltamivir 75 mg orally twice a day for 7 days. The outbreak lasted 11 days. Figure 1 shows the epidemiologic curve. Conclusion Special attention should be paid to influenza prevention in the BHUs due to the risk of spillover effect to sicker patients in the adjacent ACH. A short, 7-day course of hospital-wide oseltamivir chemoprophylaxis, in addition to promptly implementing the infection prevention measures was effective in controlling the outbreak. Disclosures All authors: No reported disclosures.

Predicting Length of Stay in an Acute Care Hospital

2001 ◽  
Vol 33 (2) ◽  
pp. 1-16 ◽  
Author(s):  
Joan Keefler ◽  
Sydney Duder ◽  
Constance Lechman
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital

scholarly journals Patient Outcomes and Lessons-Learned from Treating Patients with Severe COVID-19 at a Long-Term Acute Care Hospital

2021 ◽  
Author(s):  
Peter Grevelding ◽  
Henry C Hrdlicka ◽  
Stephen Holland ◽  
Lorraine Cullen ◽  
Amanda Meyer ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Patient Outcomes ◽  
Acute Care Hospital ◽  
Lessons Learned ◽  
Care Hospital ◽  
Patient Age ◽  
Holistic Treatment ◽  
Patient Âgé

The goal of this study was to describe the characteristics, clinical management, and patient outcomes during, and after, acute COVID-19 phase at Gaylord Specialty Healthcare, a long-term acute care hospital in Wallingford, CT, USA. In this study, we conducted a single-center retrospective analysis of electronic medical records of patients treated for COVID-19-related impairments, from March 19, 2020 through August 14, 2020, to evaluate patient outcomes in response to holistic treatment approach used at our facility. Of the 127 total COVID-19 related patient admissions during this time, 118 were discharged by the data cut-off. Mean patient age was 63 years, 64.1% were male, and 29.9% of patients tested-positive for SARS-CoV-2 infection at admission. The mean (SD) length-of-stay at was 25.5 (13.0) days and there was a positive correlation between patient age and length-of-stay. Of the 51 patients non-ambulatory at admission, 83.3% were ambulatory at discharge. Gait increased 217.4 feet from admission to discharge, a greater increase than the reference cohort of 146.3 feet. 93.8% (15/16) of patients mechanically ventilated at admission were weaned before discharge (mean 11.3 days). 74.7% (56/75) of patients admitted with a restricted diet were discharged on a regular diet. In conclusion, the majority of patients treated at our long-term acute care hospital for severe COVID-19 and related complications improved significantly through coordinated care and rehabilitation.

scholarly journals Patient Recommendations to Improve the Implementation of and Engagement With Portals in Acute Care: Hospital-Based Qualitative Study

10.2196/13337 ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. e13337 ◽  
Author(s):  
S Ryan Greysen ◽  
Yimdriuska Magan ◽  
Jamie Rosenthal ◽  
Ronald Jacolbia ◽  
Andrew D Auerbach ◽  
...  
Keyword(s):  
Acute Care ◽  
Qualitative Data ◽  
Average Length ◽  
Acute Care Hospital ◽  
Outpatient Setting ◽  
Bring Your Own Device ◽  
Inpatient Setting ◽  
Successful Implementation ◽  
Care Hospital ◽  
Patient Portals

Background The inclusion of patient portals into electronic health records in the inpatient setting lags behind progress in the outpatient setting. Objective The aim of this study was to understand patient perceptions of using a portal during an episode of acute care and explore patient-perceived barriers and facilitators to portal use during hospitalization. Methods We utilized a mixed methods approach to explore patient experiences in using the portal during hospitalization. All patients received a tablet with a brief tutorial, pre- and postuse surveys, and completed in-person semistructured interviews. Qualitative data were coded using thematic analysis to iteratively develop 18 codes that were integrated into 3 themes framed as patient recommendations to hospitals to improve engagement with the portal during acute care. Themes from these qualitative data guided our approach to the analysis of quantitative data. Results We enrolled 97 participants: 53 (53/97, 55%) women, 44 (44/97, 45%) nonwhite with an average age of 48 years (19-81 years), and the average length of hospitalization was 6.4 days. A total of 47 participants (47/97, 48%) had an active portal account, 59 participants (59/97, 61%) owned a smartphone, and 79 participants (79/97, 81%) accessed the internet daily. In total, 3 overarching themes emerged from the qualitative analysis of interviews with these patients during their hospital stay: (1) hospitals should provide both access to a device and bring-your-own-device platform to access the portal; (2) hospitals should provide an orientation both on how to use the device and how to use the portal; and (3) hospitals should ensure portal content is up to date and easy to understand. Conclusions Patients independently and consistently identified basic needs for device and portal access, education, and usability. Hospitals should prioritize these areas to enable successful implementation of inpatient portals to promote greater patient engagement during acute care. Trial Registration ClinicalTrials.gov NCT00102401; https://clinicaltrials.gov/ct2/show/NCT01970852

Patient Outcomes and Lessons-Learned from Treating Patients with Severe COVID-19 at a Long-Term Acute Care Hospital (Preprint)

2021 ◽  
Author(s):  
Peter Grevelding ◽  
Henry Charles Hrdlicka ◽  
Stephen Holland ◽  
Lorraine Cullen ◽  
Amanda Meyer ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Patient Outcomes ◽  
Acute Care Hospital ◽  
Lessons Learned ◽  
Care Hospital ◽  
Patient Age ◽  
Holistic Treatment ◽  
Patient Âgé

BACKGROUND Patients hospitalized with severe coronavirus disease-2019 (COVID-19) may face long hospital lengths-of-stay, making it unreasonable to expect a discharge to home without long-term consequences.Post-acute care, such as that provided at long-term acute care hospitals (LTACHs) can provide rehabilitation and/or palliative care in the post-COVID phase, as well as provide an alternative to conventional short-term acute care hospitalization (STACH) for active treatment, thereby reducing the burden on the STACH system. OBJECTIVE To describe characteristics, clinical management, and patient outcomes during and after acute COVID-19 phase in a LTACH in the Northeastern United States. METHODS A single-center retrospective analysis of electronic medical records of patients treated for COVID-19-related impairments, from March 19, 2020 through August 14, 2020, was conducted to evaluate patient outcomes in response to the facility’s holistic treatment approach. RESULTS Of the 127 total COVID-19 related patient admissions during this time, 118 admissions were discharged by the data cut-off. Mean patient age was 63 years, 64.1% were male, and 29.9% of patients tested-positive for SARS-CoV-2 infection at admission. The mean (SD) length-of-stay at was 25.5 (13.0) days and there was a positive correlation between patient age and length-of-stay. Of the 51 patients non-ambulatory at admission, 83.3% were ambulatory at discharge. Gait increased 217.4 feet from admission to discharge, a greater increase than the reference cohort of 146.3 feet. 93.8% (15/16) of patients mechanically ventilated at admission were weaned before discharge (mean 11.3 days). 74.7% (56/75) of patients admitted with a restricted diet were discharged on a regular diet. CONCLUSIONS The majority of patients treated at a long-term acute care hospital for severe COVID-19 and related complications improved significantly through coordinated care and rehabilitation.

scholarly journals Smart Diaper System Using Bluetooth and Smartphone to Detect Urination and Volume of Voiding Automatically: A Prospective Observational Pilot Study in an Acute Care Hospital (Preprint)

2021 ◽  
Author(s):  
Sun-Wook Kim ◽  
Jae Ho Cho ◽  
Jung‐Yeon Choi ◽  
Nak-Hyun Kim ◽  
Yejee Lim ◽  
...  
Keyword(s):  
Pilot Study ◽  
Acute Care ◽  
Detection Rate ◽  
Urine Volume ◽  
Acute Care Hospital ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
System P ◽  
Bed Sores ◽  
Detection Technologies

BACKGROUND Caregivers of patients who wear conventional diapers are required to check voiding every hour because prolonged wearing of wet diaper causes health problems including diaper dermatitis and urinary tract infection. However, frequent checking is labor-intensive and disturbs patients’ or caregivers’ sleep. Furthermore, assessing urine output of the patients with diapers in an acute care setting is difficult. Recently, a smart diaper system with wetness-detection technologies has been developed to solve these issues. OBJECTIVE We aimed to evaluate the applicability of the smart diaper system for urinary detection, its accuracy for measuring voiding volume, and incontinence-associated dermatitis (IAD) occurrence in an acute care hospital. METHODS This prospective, observational, single-arm pilot study was conducted at a single tertiary hospital. We recruited 35 participants aged ≥50 years who were wearing diapers due to incontinence between August and November 2020. When the smart diaper was wet, the smart diaper system notified the caregiver to change the diaper and measured voiding volume automatically. Caregivers were instructed to record the weight of wet diapers on the frequency-volume charts (FVCs). We determined the voiding detection rate of the smart diaper system and compared the automatically calculated urine volume by the smart diaper system with the recorded volume on FVCs. Agreement between the two measurements was estimated using the Bland-Altman plot. We also checked the occurrence or aggravation of IAD and bed sores. RESULTS A total of 30 participants completed the protocol. Three hundred and ninety episodes of urination were recorded. There were 108 records (27.7%) on the FVCs and the smart diaper system concurrently, 258 (66.2%) on the FVCs alone, 18 (4.6%) on the smart diaper system alone, and six (1.5%) on the FVCs with sensing device lost. The detection rate of the smart diaper system was 32.8% (126/384). In analysis of records concurrently listed in both the FVCs and the smart diaper system, linear regression showed a strong correlation between the two measurements (R2=0.88, P<.001). The Bland-Altman assessment showed good agreement between the two measurements with a mean difference of –4.2 ml and 95% limits of agreement between –96.7 and 88.3 ml. New occurrence or aggravation of IAD and bed sores was not observed. Bed sore was improved in one participant. CONCLUSIONS The smart diaper system showed acceptable accuracy for measuring urine volume, and it could replace the conventional FVCs in acute setting hospitals. Furthermore, the smart diaper system showed its potential advantage to prevent IAD development and bed sore worsening. However, the detection rate of the smart diaper system was below than the researchers’ expectation. Detection rate polarization among participants was observed, and improvements in user interface and convenience are needed for aged individuals who are unfamiliar to the smart diaper system.

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