Effectiveness of a new short-stay unit for elective low complexity patients’ admissions to improve patient flow
| Autor: | Alfredo Garcia, Carlos Bartolomé, Guillem Marca, Xenia Acebes, Mari Fe Viso, Berta Ortiga |
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| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Journal of Hospital Administration. 3:44 |
| ISSN: | 1927-7008 1927-6990 |
| DOI: | 10.5430/jha.v3n3p44 |
| Popis: | Background/Objective: Specialized care in an acute hospital is the highest resource consuming type of health care. Performance improvement in health care should look for a better application of medical knowledge and resource consuming at the same time as managers locally redesigned processes and organizations in order to be more cost-effective at healthcare services delivery. The aim of this study was to demonstrate the effectiveness of creating a short-stay unit for elective patients as an alternative to the elective patients being admitted in an acute ward. Methods: We included all elective patients admitted in a university hospital between the 1st of January and the 31st of December 2007, as well as those admitted during the same period of 2009, after two hospital wards transformation into a short-stay unit. We used the Hospital General Database for collecting information on years 2007 and 2009. Main key performance indicators were length of stay, pre-surgery length of stay, rotation rate, discharge planning rate and cost. For statistical bivariate analysis, we used a Chi-squared for linear trend for qualitative variables and a T -test and a Wilcoxon signed ranks test and a Mann - Whitney test for non-normal continuous variables. Significance at p < .05 was assumed throughout. Results: We included 10,678 patients, 4,423 during 2007 and 6,255 during 2009. Mean length of stay was 4.3 days (IC 95%: 4.09-4.51) in 2007 and 2.8 days (IC 95%: 2.61-3.01) in 2009 ( p < .05). Pre-surgery length of stay was reduced from 0.5 days (IC 95%: 0.44-0.56) in 2007 to 0.2 days (IC 95%: 0.17-0.23) in 2009 ( p < .05). The rotation rate was of 92 patients/bed in 2007 and of 126 patients/bed in 2009 ( p < .05). The median number of planned discharges grew from 43.05% in 2007 to 86.01% in 2009. Closing two hospital wards at weekends has generated savings of €805,376.32 through the reduction of 22 nurse employees. Conclusions: In conclusion, this approach to hospital bed management in a tertiary hospital has proven both possible and efficient. The creation of short-stay units for elective patient admissions allowed an increase in productivity per hospital bed due to a higher rotation rate and a reduction in human resources costs due to closing hospital wards at weekends. |
| Databáze: | OpenAIRE |
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