ACUTE MEDICAL ILLNESSES NECESSITATING TRANSFER FROM ACUTE REHABILITATION FACILITIES TO AN ACUTE CARE HOSPITAL: ITS EFFECT ON REHABILITATION LENGTH OF STAY AND FUNCTIONAL INDEPENDENCE

2005 ◽  
Vol 84 (3) ◽  
pp. 202-203
Author(s):  
Clinton Faulk ◽  
Scott Morioka ◽  
James Wells
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Functional Independence ◽  
Care Hospital ◽  
Rehabilitation Facilities ◽  
Acute Rehabilitation

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 MULTISENSORY STIMULATION FOR HOSPITALIZED PATIENTS WITH DEMENTIA: A PILOT STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S446-S446
Author(s):  
Sheila L Molony ◽  
Christine Waszynski
Keyword(s):  
Pilot Study ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Functional Independence Measure ◽  
Sensory Stimulation ◽  
Functional Independence ◽  
Hospitalized Patients ◽  
Mental Wellbeing ◽  
Care Hospital ◽  
Hospital Days

Abstract Introduction: Delirium occurs in up to 50% of hospitalized patients and the risk is higher in persons with dementia. Multi-sensory stimulation environments (MSSE), including trademarked “Snoezelen” rooms, have been effective in achieving positive outcomes in persons with dementia, but there have been no studies in the acute-care setting. Purpose: This pilot study tested the effect of a therapeutic Multi-sensory Stimulation Environment known as “the Hub” in an acute-care hospital. Methods: A sample of 56 patients were randomized to receive usual care or the Therapeutic Hub intervention during hospital days 2-4. Hub activities were multi-sensory and tailored based on preferences and abilities. We will describe techniques to address methodological challenges in the study with acutely ill, cognitively vulnerable participants. We will also present qualitative data describing the experience of participants receiving the Hub intervention, and will present preliminary findings regarding between group-differences in function (Functional Independence Measure), mobility, falls, wellbeing (Warwick-Edinburgh Mental Wellbeing Scale)– and person-environment relationship conceptualized as situational at-homeness (S-EOH). Conclusion: The results of this study will inform future trials on the effects of unique therapeutic environments for hospitalized persons at highest risk for delirium.

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 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.

Acute rehospitalisation during the first 3 months of in-patient rehabilitation for traumatic brain injury

2016 ◽  
Vol 40 (1) ◽  
pp. 114 ◽  
Author(s):  
Nalinda Andraweera ◽  
Richard Seemann
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
Pearson Correlation ◽  
Acute Care Hospital ◽  
Functional Independence ◽  
Care Hospital ◽  
Injury Rehabilitation ◽  
Number Of Patients ◽  
Tract Infections

Objective Unplanned re-admission to acute care hospitals during in-patient rehabilitation causes disruption to the rehabilitation program and increases the cost of health care. The aims of the present study were to identify the frequency, reasons and duration of disruption to rehabilitation because of acute re-admissions during the first 3 months of in-patient rehabilitation for traumatic brain injury (TBI) and to investigate the correlation between the duration of acute rehospitalisation and the discharge functional independence measure (FIM) score. Methods A retrospective study was conducted on patients admitted for in-patient rehabilitation following TBI to a rehabilitation hospital in Auckland, New Zealand, between January 2009 and August 2013. Data on duration and reasons for acute rehospitalisation, as well as admission and discharge FIM scores, were obtained from electronic patient records. Pearson correlation was used to evaluate the relationship between the duration of acute rehospitalisation and the discharge FIM score. Results Of the 628 patients admitted for brain injury rehabilitation, 71 (11.3%) required acute rehospitalisation within the first 3 months. The main reasons for acute rehospitalisation were preventable medical causes (43.8%), including urinary tract infections, respiratory tract infections and coronary artery disease. Of the acute re-admissions, 76.6% were within the first month of admission to the rehabilitation centre and 46.6% needed in-patient treatment in the acute care hospital for >5 days. There was a moderately strong negative correlation between the duration of stay in the acute care hospital and the discharge FIM score (r = – 0.412; P = 0.0005). Conclusion A significant number of patients admitted for in-patient rehabilitation following TBI require acute rehospitalisation due to preventable medical causes. Because the duration of acute rehospitalisation has a negative impact on rehabilitation functional gain, preventive measures and surveillance need to be further investigated and optimised. What is known about the topic? The incidence of acute rehospitalisation of patients in the community following brain injury rehabilitation is 20%–25%, with approximately half the re-admissions being for elective reasons, including orthopaedic and reconstructive surgery. What does this paper add? Unplanned acute rehospitalisation during first 3 months of in-patient rehabilitation following TBI is due to preventable causes and results in lower FIM scores on discharge. What are the implications for practitioners? An uninterrupted rehabilitation programme is vital for achieving functional outcomes.

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