scholarly journals Efficacy of a triage system to reduce length of hospital stay

2014 ◽  
Vol 204 (6) ◽  
pp. 480-485 ◽  
Author(s):  
P. Williams ◽  
E. Csipke ◽  
D. Rose ◽  
L. Koeser ◽  
P. McCrone ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Triage System ◽  
Traditional System ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Two Systems ◽  
Admission System ◽  
Novel Method

BackgroundAttempts have been made to improve the efficiency of in-patient acute care. A novel method has been the development of a ‘triage system’ in which patients are assessed on admission to develop plans for discharge or transfer to an in-patient ward.AimsTo compare a triage admission system with a traditional system.MethodLength of stay and readmission data for all admissions in a 1-year period between the two systems were compared using the participating trust's anonymised records.ResultsDespite reduced length of stay on the actual triage ward, the average length of stay was not reduced and the triage system did not lead to a greater number of readmissions. There was no significant difference in costs between the two systems.ConclusionsBased on our findings we cannot conclude that the triage system reduced length of stay, but we can conclude that it does not increase the number of readmissions as some have feared.

Impact of orthogeriatric management on the average length of stay of patients aged over seventy five years admitted to hospital after hip fractures

2021 ◽  
Author(s):  
Pierre-Sylvain Marcheix ◽  
Camille Collin ◽  
Jérémy Hardy ◽  
Christian Mabit ◽  
Achille Tchalla ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hip Fracture ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Average Length ◽  
Discharge Rate ◽  
Length Of Hospital Stay ◽  
Median Length ◽  
Average Length Of Stay ◽  
Significant Difference

Abstract Introduction Hip fracture is a frequent and serious condition in the elderly. We conducted a retrospective cohort study to answer the following questions: (1) Could treatment in an orthogeriatric unit help to reduce the average length of stay for patients aged over 75 years admitted to hospital for the treatment of a hip fracture?; and (2) Could such treatment influence the post-operative outcomes of patients with hip fracture? Methods and materials Our study included 534 patients admitted to hospital between January 2017 and December 2018 for surgical treatment of a hip fracture. We compared 246 patients who received traditional orthopaedic care with 288 patients treated in an orthogeriatric unit. Results Our cohort included 410 women (77%). The average age was 87.5 ± six years, and 366 patients (68%) were living at home prior to the fracture. A statistically significant difference in median length of stay (from 10 to 9 days) was observed between patients who did and did not receive orthogeriatric unit treatment (groups 1 and 2; 95% CI: 0.64; 2.59; p = 0.001). There was no difference in pre-operative delay, intra-hospital mortality rate, place of recovery, rate of institutionalisation after six months, or the number of new fractures at 6 months between the groups. The mortality rate after six months was 23.6% and 21.3% in groups 1 and 2, respectively; the difference was not significant. Discussion Orthogeriatric unit treatment reduced the median length of stay by one day, in line with most previous studies. According to Pablos-Hernandez et al., multifaceted orthogeriatric treatment is most effective. In our study, only 38% of the patients received surgical treatment within 48 hours, where early surgery is key for reducing the length of hospital stay. The intrahospital mortality rate was 2.6%, which is comparable to literature data. The discharge rate did not differ by orthogeriatric treatment status, which is also consistent with previous findings (e.g. Gregersen et al.). Lastly, the mortality rate after six months was slightly reduced by orthogeriatric care. In line with this, Boddaert et al. reported a difference in mortality rate after six months between groups who did and did not receive orthogeriatric treatment (15% vs. 24%).

Predicting the impact of new health technologies on average length of stay: Development of a prediction framework

2005 ◽  
Vol 21 (4) ◽  
pp. 487-491 ◽  
Author(s):  
Sue Simpson ◽  
Claire Packer ◽  
Andrew Stevens ◽  
James Raftery
Keyword(s):  
Length Of Stay ◽  
Health Management ◽  
Average Length ◽  
New Technology ◽  
Length Of Hospital Stay ◽  
Health Technologies ◽  
Average Length Of Stay ◽  
Admission Policies ◽  
Mechanism Of Impact ◽  
The Impact

Objectives: The aim of this study was to develop a framework to predict the impact of new health technologies on average length of hospital stay.Methods: A literature search of EMBASE, MEDLINE, Web of Science, and the Health Management Information Consortium databases was conducted to identify papers that discuss the impact of new technology on length of stay or report the impact with a proposed mechanism of impact of specific technologies on length of stay. The mechanisms of impact were categorized into those relating to patients, the technology, or the organization of health care and clinical practice.Results: New health technologies have a variable impact on length of stay. Technologies that lead to an increase in the proportion of sicker patients or increase the average age of patients remaining in the hospital lead to an increase in individual and average length of stay. Technologies that do not affect or improve the inpatient case mix, or reduce adverse effects and complications, or speed up the diagnostic or treatment process should lead to a reduction in individual length of stay and, if applied to all patients with the condition, will reduce average length of stay.Conclusions: The prediction framework we have developed will ensure that the characteristics of a new technology that may influence length of stay can be consistently taken into consideration by assessment agencies. It is recognized that the influence of technology on length of stay will change as a technology diffuses and that length of stay is highly sensitive to changes in admission policies and organization of care.

scholarly journals 1114 Getting it Right First Time: An Audit of Length of Hospital Stay for Mandibular Fractures

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
F Mitchell ◽  
J Parmar
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Maxillofacial Surgery ◽  
Length Of Hospital Stay ◽  
National Standard ◽  
Oral And Maxillofacial Surgery ◽  
Service Improvement ◽  
Mandibular Fractures ◽  
Average Length Of Stay ◽  
Mandible Fractures

Abstract Introduction GIRFT is a Department of Health programme, created to improve efficiency by providing data that gives departments a national standard to encourage reflection and service-improvement. The 2016 document in Oral and Maxillofacial Surgery, suggests the national average length of stay for isolated mandible fractures was 2 days, 1 day pre-operatively and 1 day post-operatively. This Audit aimed to investigate if all admissions in our trust met this standard, as a short stay reduces costs and improves patient experience. Method Data was collected for all isolated mandibular fracture admissions between January – September 2019, with 89 patients identified. Date of admission, surgery and discharge was recorded which allowed calculation of pre-operative, post-operative, and total stay. Results 78% of patients had surgery within 24 hours of admission. Admissions on a Saturday were most often delayed, with a mean pre-operative stay of 1.60 days and total stay of 2.55 days. Commonly the reason for delay was not recorded, or due to lack of theatre space. 92% of patients were discharged within 24 hours post-operatively. The average length of stay met the 2-day standard, with Monday admissions having the shortest average stay of 1.45 days. Conclusions Whilst the majority of patients are treated and discharged within 2 days, improvements and future audit would assist to get closer to the 100% target. Saturday saw the highest number of admissions, which also had the longest average length of stay. A dedicated weekend trauma list would reduce wait times but may be limited by staffing and theatre space.

scholarly journals Contribution of the BioFire® FilmArray® Meningitis/Encephalitis Panel:

2019 ◽  
Vol 12 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Kyle Dack ◽  
Stephanie Pankow ◽  
Elizabeth Ablah ◽  
Rosey Zackula ◽  
Maha Assi
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Medical Center ◽  
Antiviral Treatment ◽  
Length Of Hospital Stay ◽  
Average Length Of Stay ◽  
Regional Medical ◽  
Regional Medical Center ◽  
The Mean ◽  
Hospital Stay Duration

Introduction. Traditional evaluation of meningitis includes cerebrospinalfluid (CSF) culture and gram stain to pinpoint specific causalorganisms. The BioFire® FilmArray® Meningitis/Encephalitis (ME)Panel has been implemented as a more timely evaluation method.This study sought to assess if the BioFire® ME Panel was associatedwith a decreased length of stay or decreased antimicrobial durationwhen used in the diagnosis of meningitis or encephalitis.Methods.xA case, historical-control, chart review was performed onpatients admitted to a regional medical center with CSF pleocytosisduring Cohort 1 (the year prior to BioFire® ME Panel implementation)and Cohort 2 (the year after BioFire® ME Panel implementation).Length of hospital stay, duration of antimicrobials, and BioFire® MEPanel result were gathered and analyzed.Results. Average length of stay for both cohorts was about fourhospital days. Approximately three-fourths of all patients receivedantibiotic/antiviral treatment with an average of three days duration.No significant differences were observed between groups. The mean(median) duration of antimicrobials in the year prior to and afterthe BioFire® ME Panel implementation was 3.6 (3) and 3.1 (2) days,respectively (p = 0.835). The mean (median) length of stay in the yearprior to and after the BioFire® ME Panel implementation was 5.8 (4)and 5.4 (4) days, respectively (p = 0.941). Among the patients admittedafter the implementation of the BioFire® ME Panel, 4.3 % (n =2) had a positive bacterial result, 38.3% (n = 18) had a positive viralresult, and 57.4% (n = 27) had a negative result. Of the 27 negativeresults, 77.8% (n = 21) were treated with antimicrobial medication.Conclusions. This study suggested there is no difference betweenlength of stay or antimicrobial duration in presumed meningitis casesassessed with traditional methods as compared to the BioFire® MEPanel. Kans J Med 2019;12(1):1-3.

THE AVERAGE LENGTH OF STAY IN THE HOSPITAL OF INFANTS BORN PREMATURELY

PEDIATRICS ◽  
1948 ◽  
Vol 1 (1) ◽  
pp. 66-69
Author(s):  
HELEN M. WALLACE ◽  
LEONA BAUMGARTNER ◽  
MOLLY L. PARK
Keyword(s):  
Length Of Stay ◽  
American Literature ◽  
Premature Infants ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Care Program ◽  
Average Length Of Stay ◽  
Private Agency ◽  
Pediatric Consultation ◽  
Basic Medical

Any public or private agency administering a medical care program needs certain basic medical data to plan its program. In the field of maternal and child health, one fact of importance is the average length of hospital stay of newly born premature infants. This basic data assists in planning for such budgetary items as: reimbursement for hospital care; payment for pediatric consultation service; and estimation of the number of beds(incubators, heated cribs and bassinets) needed to care for the total number of premature infants born annually in any community. A review of the American literature for the past twenty years reveals that there is relatively little information on the average length of stay of newly born premature infants in hospitals. Table I summarizes the information available. It will be seen from Table I that there is considerable variation in the method of reporting. Some authors do not include premature infants weighing more than 5 pounds at birth; others include premature infants weighing more than 5½ pounds. There is also variation as to whether a particular series includes the premature infants who die in the hospital, as well as those who are discharged alive. Table I shows that, for the series including only those infants who survived in the hospital, the average stay ranges from 17.3 to 28.8 days, with the majority falling between 24 and 28 days. For the series including both the premature infants who survived and those who died in the hospital, the average stay ranges from

Associations between gender and outcome of acute psychiatric admission, looking specifically at length of stay and type of admission

2017 ◽  
Vol 41 (S1) ◽  
pp. s901-s901
Author(s):  
J. Beezhold ◽  
U. Farooq ◽  
J. Isaac ◽  
A. Shepherd
Keyword(s):  
Length Of Stay ◽  
Gender Bias ◽  
Legal Status ◽  
Average Length ◽  
Psychiatric Inpatient ◽  
Published Data ◽  
Psychiatric Admission ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Competing Interest

IntroductionThere is little published data regarding the association between gender and outcomes in acute inpatient psychiatry. We present outcomes from a study of 5601 acute psychiatric admissions.ObjectiveThe objective of this study was to identify associations between gender and outcome of acute psychiatric admission, looking specifically at length of stay and at whether they were detained in hospital.MethodsThe relationship between gender and acute psychiatric inpatient length of stay and detention status was analyzed for all admissions over 90 months from Sept 2002 to Feb 2010. There were 5601 consecutive admissions included in this study, 2862 of which were male and 2739 were female. There were no exclusions. Data was complete for more than 99% of subjects, and was extracted from part of routine service data on an anonymous- basis. The subjects were admitted into two acute inpatient wards in central Norfolk. Data was analyzed using SPSS. Ethics consent was granted by the research ethics committee.ResultsThe study showed no significant difference in average length of stay (female = 32.98, male = 32.11; P = 0.595). Additionally, no significant difference was found linking gender to detention status (26% female, 25% male; P = 0.517) as opposed to informal or voluntary admission.ConclusionThe study found no evidence of a gender bias regarding overall length of stay and legal status in acute admissions. Further research should be conducted in this area to examine whether there is any gender bias in outcomes relating to diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Relationship between nutritional status and length of hospital stay in oncological surgery.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13591-e13591
Author(s):  
Carl Meissner ◽  
Ronny Otto ◽  
Joerg Fahlke ◽  
Mathias Mueller ◽  
Karsten Ridwelski
Keyword(s):  
Length Of Stay ◽  
Nutritional Status ◽  
Hospital Stay ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Nutritional Therapy ◽  
Albumin Level ◽  
Average Length Of Stay

e13591 Background: In Germany, a serious illness is the main cause of malnutrition. Various studies have already shown that the length of time in hospital for various diseases and operations in malnourished patients increases. This leads to a deterioration in the quality of life of the patient and results in considerable costs for the health care system. Methods: In order to investigate the relationship between nutritional status and length of hospital stay, a patient group of 363 patients who had a tumor with the primary tumor in the gastrointestinal tract was first identified. All patients had an NRS score of 3 or greater and a meaningful laboratory with regard to protein and albumin levels and / or results of a bioelectrical impedance analysis. The average length of stay for these patients was determined depending on the various parameters. Results: The present study shows that malnourished patients have to stay in the hospital for between 2 and 11.1 days longer. When evaluating the NRS score, the protein and albumin level as well as the BCM and the ECM / BCM index, a longer hospital stay of malnourished patients compared to those who were not malnourished was demonstrated. The BMI is an insufficient parameter to describe the nutritional status. An extension of the length of hospital stay cannot be demonstrated only on the basis of the BMI. Conclusions: Since an inadequate nutritional status obviously affects the length of hospital stay in oncological patients, they should be examined early for malnutrition. The length of stay can be shortened through nutritional therapy measures, which also leads to a significant reduction in costs.

scholarly journals Outcomes of Extravesical Versus Intravesical Ureteral Reimplantation

2004 ◽  
Vol 4 ◽  
pp. 195-197
Author(s):  
Leah P. McMann ◽  
Byron D. Joyner
Keyword(s):  
Length Of Stay ◽  
Vesicoureteral Reflux ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Renal Ultrasound ◽  
Voiding Cystourethrogram ◽  
Ureteral Reimplantation ◽  
Success Rates ◽  
Average Length Of Stay

Purpose: The purpose of our study was to examine outcomes and compare length of stay after extravesical and intravesical ureteral reimplantation at our institution. Materials and Methods: Retrospective review was performed of 30 patients (55 ureters) with vesicoureteral reflux who underwent either the Cohen (intravesical) cross-trigonal procedure or the extravesical (detrusorrhaphy) approach. Each patient had documented follow-up consisting of a postoperative renal ultrasound and/or a voiding cystourethrogram (VCUG). Inclusion criteria was the presence of primary vesicoureteral reflux. Exclusion criteria were patients who had undergone a previous repair and patients in whom results of neither the renal ultrasound nor the VCUG were available. Results: There were no significant cases of obstruction or wound infection with either approach. Two patients who underwent the extravesical approach had persistent reflux on VCUG three months postoperatively, but both resolved by fifteen months. Average length of stay was only 3.00 ± 1.33 days for the extravesical approach, compared to 5.36 ± 1.75 days for the intravesical approach ( P = .0003 ). Conclusions: Given that by fifteen months success rates were the same with either approach, the extravesical approach is comparable to the intravesical technique and is a viable option in terms of outcome and economics given the shorter length of hospital stay.

scholarly journals 55 A Review of Stroke Demographics and Outcomes at a Regional Hospital without a Stroke Unit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Lushen Pillay ◽  
Kushan Galav ◽  
Deeptish Tulsi ◽  
Joanna McGlynn ◽  
John Doherty ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Length Of Stay ◽  
Stroke Unit ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Local Analysis ◽  
Stroke Patients ◽  
Stroke Units ◽  
Average Length Of Stay ◽  
Stroke Register

Abstract Background According to the 2017 National Stroke Register Report; 75% of strokes occur in patients aged 65 years and older. Within the audit 19 stroke units reported that 70.6% of stroke patients were admitted to a stroke unit and their median length of stay of 9 days. Numerous studies have shown better outcomes in patients admitted to a stroke unit versus a medical unit leading to national stroke networks and bypass protocols for patients. However, stroke patients can still be found in non-stroke unit hospitals such as our own. Methods Demographics from HIPE data was collected on all stroke patients admitted to our hospital between January 1st and December 31st 2017. Basic statistical methods were used to analyse the data. Results We analyzed 103 patient records. The average age at presentation was 73 years (range: 35-97) and 60.1% were males. The average length of hospital stay was 16.1 days (range 1- 130 days). Ischemic (77%) events were more common than haemorrhagic events (23%). The three most common co-morbidities were hypertension (45%), hyperlipidemia (30%) and atrial fibrillation (19%). Discharge destination was home (66%), nursing home (14%), national rehabilitation (2%) and an 18% mortality rate within 3 months. The mortality rate was higher in the hemorrhagic (42%) compared to ischemic (11%). Conclusion The average length of stay was 16.1 days, considerably higher than the national stroke unit average of 9. The overall mortality rate was 5% higher than the national of 13%. Limited rehabilitation services and time awaiting national rehabilitation beds contributed to the long LOS. There is a definite need for a dedicated stroke service at our hospital, local analysis suggests that 6 beds would meet the needs of our catchment area; and this would lead to better outcomes for stroke patients. A further locally dedicated stroke audit is needed.

scholarly journals Early Ambulation in Hip Replacement Patients Regarding Length of Hospital Stay

2021 ◽  
Vol 2 (2) ◽  
pp. 30-34
Author(s):  
Jayme Bristol
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Research Study ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Early Ambulation ◽  
Total Hip ◽  
Average Length Of Stay

Background: Total hip replacement surgeries are one of the most common orthopedic surgeries performed today1. This number continues to rise. One way to accommodate the growing need for inpatient orthopedic beds is through high hospital turnover. High turnover can possibly be accomplished through early ambulation. The goal of the study is to see if standing or walking before eight hours post-operative decreased overall length of hospital stay. Methods: This research study is a retrospective chart review that looked at 92 randomly selected general anesthesia total hip replacement patients from Nebraska Medicine in Omaha, NE from August 2017 to August 2018. This research study makes a clear definition of early ambulation after total hip replacement surgery: standing or walking within eight hours of surgery. Results: From the analyzed research the average length of stay for all 92 total hip replacement patients was 4.23 days. For those total hip replacement patients who were ambulated within eight hours of surgery completion the average length of stay was 2.83 days. For the total hip replacement patients who were ambulated after eight hours of surgery completion the average length of stay was 5.14 days. Conclusion: There is a statistically significant difference in length of hospital stay for total hip replacement patients at Nebraska Medicine who were ambulated within eight hours of surgery completion compared to those who were not.

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