scholarly journals Reducing Hospital Lengths of Stay in the Epidemic

2021 ◽  
Vol 10 (02) ◽  
pp. 39-45
Author(s):  
Ronald Lagoe ◽  
Mark Murphy ◽  
Shelly Littau
Keyword(s):  
Lengths Of Stay

Modelling In-Patient Bed Usage Behaviour in a Department of Geriatric Medicine

1993 ◽  
Vol 32 (01) ◽  
pp. 79-81 ◽  
Author(s):  
P. Millard ◽  
S. McClean
Keyword(s):  
Census Data ◽  
Geriatric Medicine ◽  
Temporal Trends ◽  
Exponential Model ◽  
Bed Occupancy ◽  
Lengths Of Stay ◽  
Geriatric Hospital ◽  
Using Data ◽  
Acute Patients

Abstract:The flow of patients through geriatric hospitals has been previously described in terms of acute and long-stay states where the bed occupancy at a census point is modelled by a mixed exponential model. Using data for sixteen years the model was fitted to successive annual census points, in order to provide a description of temporal trends. While the number of acute patients has remained fairly stable during the period, the model shows that there has been a decrease in the number of long-stay patients. Mean lengths of stay in our geriatric hospital before death or discharge have decreased during the study period for both acute and long-stay patients.Using these fits of the mixed exponential model to census data, a method is provided for predicting future turnover of patients. These predictions are reasonably good, except when the turnover patterns go through a period of flux in which assumption of stability no longer holds. Overall, a methodology is presented which relates census analysis to the behaviour of admission cohorts, thus producing a means of predicting future behaviour of patients and identifying where there is a change in patterns.

scholarly journals Association of Iron Supplementation Programs with Iron-Deficiency Anemia Outcomes among Children in Brazil

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1524
Author(s):  
Carolina Thalya da Silva Paulino ◽  
Marislei Nishijima ◽  
Flavia Mori Sarti
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Fixed Effects ◽  
Iron Supplementation ◽  
Deficiency Anemia ◽  
Federal Programs ◽  
Government Programs ◽  
Lengths Of Stay ◽  
Social Inequities ◽  
High Prevalence

Anemia remains a condition with high prevalence in populations worldwide, and the prevalence of anemia among children under five years old in Brazil is approximately 40%, being higher in communities marked by social inequities. Diverse government programs during recent decades targeted iron-deficiency anemia, considering its impacts throughout the lifetime. The objective of this study was to investigate the effects of two government iron supplementation programs on health outcomes related to iron-deficiency anemia among children up to 4 years old in Brazilian municipalities. A longitudinal panel encompassing data from 5570 municipalities from 1998 to 2019 was investigated using a difference-in-differences framework with multiple interventions and distinct times of adhesion, and fixed-effects models were estimated to control for invariant municipal characteristics throughout the period in order to ensure comparability. The results indicate significant effects of the federal programs in reducing hospitalizations and lengths of stay due to iron-deficiency anemia, especially in non-poor municipalities. There was complementarity in the effects of the programs; however, neither of the programs influenced mortality rates. Thus, it is important to consider possible improvements in the operationalization of the programs, in order to achieve better results in the reduction of severe iron-deficiency anemia among children up to 4 years old.

scholarly journals Estimating lengths-of-stay of hospitalized COVID-19 patients using a non-parametric model: a case study in Galicia (Spain)

2021 ◽  
pp. 1-14
Author(s):  
Ana López-Cheda ◽  
María-Amalia Jácome ◽  
Ricardo Cao ◽  
Pablo M. De Salazar
Keyword(s):  
Parametric Model ◽  
Lengths Of Stay ◽  
Non Parametric

Pattern Recognition of Travel Mobility in a City Destination: Application of Network Motif Analytics

2021 ◽  
pp. 004728752110247
Author(s):  
Sangwon Park ◽  
Ren Ridge Zhong
Keyword(s):  
Network Science ◽  
Network Motif ◽  
Interdisciplinary Approach ◽  
Movement Patterns ◽  
Urban Tourism ◽  
Lengths Of Stay ◽  
Sustainable Planning ◽  
Total Movement ◽  
City Network ◽  
Travel Behaviors

Urban tourism is considered a complex system. Tourists who visit cities have diverse purposes, leading to multifaceted travel behaviors. Understanding travel movement patterns is crucial in developing sustainable planning for urban tourism. Built on network science, this article discusses 12 key topologies of travel patterns/flow occurring in a city network by applying network motif analytics. The 12 significant types of travel mobility can account for approximately 50% of the total movement patterns. In addition, this study presents variations in travel movement patterns depending on not only different lengths of stay in topological structures of travel mobility, but also relative proportions of each type. As a result, this article suggests an interdisciplinary approach that adopts the network science method to better understand city travel behaviors. Important methodological and practical implications that could be useful for city destination planners are suggested.

627 Strategies for Reducing Emergency Department Lengths of Stay for Admitted Pediatric Burn Patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S169-S169
Author(s):  
Lisa M Shostrand ◽  
Brett C Hartman ◽  
Belinda Frazee ◽  
Dawn Daniels ◽  
Madeline Zieger
Keyword(s):  
Emergency Department ◽  
Gap Analysis ◽  
Burn Patients ◽  
Improvement Project ◽  
Burn Trauma ◽  
Charge Nurse ◽  
Lengths Of Stay ◽  
Burn Unit ◽  
Set Up ◽  
Trauma Activation

Abstract Introduction Various strategies to reduce emergency department (ED) lengths of stay (LOS) for admitted pediatric burn patients may be employed as a quality improvement project. Decreasing ED LOS may promote patient outcomes and reduce morbidity. Initial discussions were brought forth during trauma and burn multidisciplinary peer review rounds in March 2019 and have persisted to present day. Methods Several strategies, such as preparation of the burn unit staff within one hour of patient arrival in ED, notification to the burn unit by the burn attending of an incoming pediatric burn patient, allowing the PICU charge nurses or advisors to assist with room set up and admissions, and creating a checklist to assist PICU nurses and advisors in helping prepare for anticipating inpatient admissions. These strategies were designed and enforced in March/April 2019. In addition to these action plans, trauma activation alerts were added in December 2019 to the burn charge nurse phone for pediatric burn trauma one and trauma alerts for more expedient notifications. Finally, communication efforts between ED and burn leadership teams were conducted in June 2020 to help with additional mitigating of ED LOS, such as discussing the appropriateness of specialty consults while in the ED. Results Initial ED LOS was reduced from 209 minutes in March 1019 to 150 minutes in June 2019. Increased trends were noted in early 2020, with a peak at 244 minutes in July 2020. Additional interventions, such as trauma activation alerts and ED/Burn team communications, did not provide sustainable long-term reductions. Conclusions Recent strategies to reduce overall ED LOS trends have been beneficial, but not consistent, in sustaining downward trends. Action to perform a gap analysis to discover persistent barriers and to introduce additional structure, such as a burn trauma one algorithm, may provide stability to this metric.

Topical Lidocaine Patch for Postthoracotomy and Poststernotomy Pain in Cardiothoracic Intensive Care Unit Adult Patients

2019 ◽  
Vol 39 (5) ◽  
pp. 51-57 ◽  
Author(s):  
Michael Liu ◽  
Mabel Wai ◽  
James Nunez
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Standard Care ◽  
Academic Medical Center ◽  
Adult Patients ◽  
Control Group ◽  
Lidocaine Group ◽  
Lengths Of Stay ◽  
Topical Lidocaine

Background Transdermal lidocaine patches have few systemic toxicities and may be useful analgesics in cardiac surgery patients. However, few studies have evaluated their efficacy in the perioperative setting. Objective To compare the efficacy of topical lidocaine 5% patch plus standard care (opioid and nonopioid analgesics) with standard care alone for postthoracotomy or poststernotomy pain in adult patients in a cardiothoracic intensive care unit. Methods A single-center, retrospective cohort evaluation was conducted from January 2015 through December 2015 in the adult cardiothoracic intensive care unit at a tertiary academic medical center. Cardiac surgery patients with new sternotomies or thoracotomies were included. Patients in the lidocaine group received 1 to 3 topical lidocaine 5% patches near sternotomy and/or thoracotomy sites daily. Patches remained in place for 12 hours daily. Patients in the control group received standard care alone. Results The primary outcome was numeric pain rating for sternotomy/thoracotomy sites. Secondary outcomes were cardiothoracic intensive care unit and hospital lengths of stay and total doses of analgesics received. Forty-seven patients were included in the lidocaine group; 44 were included in the control group. Mean visual analogue scores for pain did not differ between groups (lidocaine, 2; control, 1.9; P = .58). Lengths of stay were similar for both groups (cardiothoracic intensive care unit: lidocaine, 3.06 days; control, 3.11 days; P = .86; hospital: lidocaine, 8.26 days; control, 7.61 days; P = .47). Conclusions Adjunctive lidocaine 5% patches did not reduce acute pain in postthoracotomy and post-sternotomy patients in the cardiothoracic intensive care unit.

scholarly journals 448. Disproportionate Burden of COVID-19 on Latinx Residents among Hospitalized Patients at San Francisco’s Public Health Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S292-S292
Author(s):  
Vivek Jain ◽  
Lillian B Brown ◽  
Carina Marquez ◽  
Luis Rubio ◽  
Natasha Spottiswoode ◽  
...  
Keyword(s):  
Public Health ◽  
African American ◽  
San Francisco ◽  
Ethnic Disparities ◽  
Food Service ◽  
Lengths Of Stay ◽  
Hospital Deaths ◽  
Health Hospital ◽  
Disproportionate Burden ◽  
Overall Mortality

Abstract Background San Francisco implemented one of the earliest shelter-in-place public health mandates in the U.S., with flattened curves of diagnoses and deaths. We describe demographics, clinical features and outcomes of COVID-19 patients admitted to a public health hospital in a high population-density city with an early containment response. Methods We analyzed inpatients with COVID-19 admitted to San Francisco General Hospital (SFGH) from 3/5/2020–5/11/2020. SFGH serves a network of >63,000 patients (32% Latinx/24% Asian/19% African American/19% Caucasian). Demographic and clinical data through 5/18/2020 were abstracted from hospital records, along with ICU and ventilator utilization, lengths of stay, and in-hospital deaths. Results Of 157 admitted patients, 105/157 (67%) were male, median age was 49 (range 19-96y), and 127/157 (81%) of patients with COVID-19 were Latinx. Crowded living conditions were common: 60/157 (38%) lived in multi-family shared housing, 12/1578 (8%) with multigenerational families, and 8/157 (5%) were homeless living in shelters. Of 102 patients with ascertained occupations, most had frontline essential jobs: 23% food service, 14% construction/home maintenance, and 10% cleaning. Overall, 86/157 (55%) of patients lived in neighborhoods home to majority Latinx and African-American populations. Overall, 45/157 (29%) of patients needed ICU care, and 26/157 (17%) required mechanical ventilation; 20/26 (77%) of ventilated patients were successfully extubated, and 137/157 (87%) were discharged home. Median hospitalization duration was 4 days (IQR, 2–10), and only 6/157 (4%) patients died in hospital. Conclusion In San Francisco, where early COVID-19 mitigation was enacted, we report a stark, disproportionate COVID-19 burden on Latinx patients, who accounted for 81% of hospitalizations despite making up only 32% of the patient base and 15% of San Francisco’s total population. Latinx inpatients frequently lived in high-density settings, increasing household risk, and frequently worked essential jobs, potentially limiting the opportunity to effectively distance from others. We also report here favorable clinical outcomes and low overall mortality. However, an effective COVID-19 response must urgently address racial and ethnic disparities. Disclosures All Authors: No reported disclosures

scholarly journals Patient vs Provider Characteristics Impacting Hospital Lengths of Stay After Total Knee or Hip Arthroplasty

2011 ◽  
Vol 26 (8) ◽  
pp. 1418-1426.e2 ◽  
Author(s):  
Joseph F. Styron ◽  
Siran M. Koroukian ◽  
Alison K. Klika ◽  
Wael K. Barsoum
Keyword(s):  
Hip Arthroplasty ◽  
Lengths Of Stay ◽  
Provider Characteristics ◽  
Total Knee

Community Capacity to Provide Mental/Behavioral Health Services for People With IDD Transitioning From State-Operated Developmental Centers

2021 ◽  
Vol 59 (3) ◽  
pp. 224-238
Author(s):  
Amie Lulinski ◽  
Tamar Heller
Keyword(s):  
Health Services ◽  
Behavioral Health ◽  
Psychiatric Diagnosis ◽  
Technical Assistance ◽  
Community Capacity ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Individual Level ◽  
Lengths Of Stay ◽  
Survey Results

Abstract The study's aim was to explore the capacity of community-based providers of residential supports and services to support people with intellectual and developmental disabilities who transitioned out of state-operated institutions into community-based settings. Receiving agency survey results from 65 agencies and individual-level variables of 2,499 people who had transitioned from an institution to a community-based setting indicated that people who returned to an institution post-transition tended to be younger, have a higher IQ score, were more likely to have a psychiatric diagnosis, tended to have shorter previous lengths of stay at an institution, transitioned to larger settings, and received services from an agency receiving behavioral health technical assistance as compared to those who remained in their transition settings.

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