Decreased Pediatric Trauma Length of Stay and Improved Disposition With Implementation of Lewin's Change Model
| Autor: | Ibrahim Abd El-Shafy, Nathan A.M. Christopherson, Danielle Sargeant, Jose M Prince, Jennifer Zapke |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Child Health Services MEDLINE New York Collaborative Care Trauma registry Change model Emergency Nursing Critical Care Nursing Patient Readmission Trauma Centers medicine Humans Hospital Mortality Registries Child Advanced and Specialized Nursing business.industry Health Plan Implementation Admission rate Disposition Length of Stay medicine.disease Readmission rate Models Organizational Emergency medicine Wounds and Injuries Female business Pediatric trauma |
| Zdroj: | Journal of trauma nursing : the official journal of the Society of Trauma Nurses. 26(2) |
| ISSN: | 1078-7496 |
| Popis: | Although often cared for nonoperatively, trauma is a surgical disease managed by surgical services in a multidisciplinary manner. The American College of Surgeons Committee on Trauma (ACS COT) emphasizes this as part of the ACS COT verification process and expects nonsurgical service admission rate of less than 10%. In this project, we developed a collaborative care model captained by surgical services with medical service consultation to achieve this goal for optimal care of injured patients. The project was conducted at a freestanding pediatric trauma center undergoing verification as a Level 1 ACS COT pediatric trauma center. The trauma registry was utilized to obtain nonsurgical service admission rate from January 2011 to June 2015. Lewin's 3-Step Model was utilized to guide change. Adherence to the new ACS standards was continually tracked and fallouts were addressed on an individual basis. Overall compliance was reported routinely through trauma and hospital quality programs. Individual successes and accomplishments were recognized and reinforced. At the inception of the project, nonsurgical admission rate was 30%. Implementation of Lewin's 3-Step Model nonsurgical admission rate decreased to 3%, representing a reduction of 27%. In addition, a 21% reduction in hospital length of stay, 3.78-3 days, was demonstrated with no change in 30-day readmission rate. Lewin's change model facilitated culture change to achieve ACS COT standards and reduced nonsurgical admissions to less than 10%. Reduction in hospital length of stay supports an improvement in the efficiency of care when directed by the pediatric trauma surgery team. |
| Databáze: | OpenAIRE |
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