Making Greater Use Of Dedicated Hospital Observation Units For Many Short-Stay Patients Could Save $3.1 Billion A Year

2012 ◽  
Vol 31 (10) ◽  
pp. 2314-2323 ◽  
Author(s):  
Christopher W. Baugh ◽  
Arjun K. Venkatesh ◽  
Joshua A. Hilton ◽  
Peter A. Samuel ◽  
Jeremiah D. Schuur ◽  
...  
Keyword(s):  
Short Stay ◽  
Observation Units ◽  
Short Stay Patients

Extending the Sydney Triage to Admission Risk Tool (START+) to predict discharges and short stay admissions

2018 ◽  
Vol 35 (8) ◽  
pp. 471-476 ◽  
Author(s):  
Anja Ebker-White ◽  
Kendall J Bein ◽  
Michael M Dinh
Keyword(s):  
Area Under Curve ◽  
Primary Outcome ◽  
Predictive Accuracy ◽  
Short Stay ◽  
Extended Version ◽  
Observation Units ◽  
Registration Number ◽  
Overall Performance ◽  
A Prospective Study ◽  
Sydney Australia

ObjectiveThis study aims to validate previously reported triage tool titled Sydney Triage to Admission Risk Tool (START+) and investigate whether an extended version of the tool could be used to identify and stream appropriate short stay admissions to ED observation units or specialised short stay inpatient wards.MethodsThis was a prospective study at two metropolitan EDs in Sydney, Australia. Consecutive triage encounters were observed by a trained researcher and START scores calculated. The primary outcome was length of stay <48 hours. Multivariable logistic regression was used to estimate area under curve of receiver operator characteristic (AUROC) for START scores. The original START tool was then extended to include frailty and multiple or major comorbidities as additional variables to assess for further predictive accuracy.ResultsThere were 894 patients analysed during the study period. Of the 894 patients, there were 732 patients who were either discharged from ED or admitted for <2 days. The AUROC for the original START+ tool was 0.80 (95% CI 0.77 to 0.83). The presence of frailty was found to add a further five points and multiple comorbidities added another four points on top of the START score, and the AUROC for the extended START score 0.84 (95% CI 0.81 to 0.88).ConclusionThe overall performance of the extended ED disposition prediction tool that included frailty and multiple medical comorbidities significantly improved the ability of the START tool to identify patients likely to be discharged from ED or require short stay admission <2 days.Trial registration numberACTRN12618000426280

Disputes over payments for short stay patients are wasting NHS time, says watchdog

BMJ ◽  
2012 ◽  
Vol 344 (apr19 2) ◽  
pp. e2868-e2868
Author(s):  
N. Hawkes
Keyword(s):  
Short Stay ◽  
Short Stay Patients

Effects of consultant residence out-of-hours on acute paediatric admissions

2020 ◽  
Vol 105 (7) ◽  
pp. 661-663 ◽  
Author(s):  
Robert Scott-Jupp ◽  
Emily Carter ◽  
Nick Brown
Keyword(s):  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Time Of Day ◽  
Short Stay ◽  
Night Time ◽  
Out Of Hours ◽  
Duration Of Stay ◽  
Binomial Regression ◽  
Rate Ratios ◽  
Short Stay Patients

Acute paediatric units require round-the-clock skilled resident medical cover. Fully trained doctors remaining resident on-site at night and weekends may improve care at these times, but costs are higher. In compensation, more senior doctors may be less likely to admit children.MethodsIn a unit providing 24-hour, 7-day acute services, out-of-hours resident cover has been divided between level 2/3 trainees and consultants. Between 2007 and 2017, night and weekend day shifts were identified as resident consultant or non-resident consultant. Admission numbers (duration of stay of ≥4 hours) were obtained from hospital activity databases. Analyses were undertaken on total admissions and stratified by time of day and duration of stay of >12 or < 12 hours. Incidence rate ratios (IRRs) were derived using negative binomial regression .ResultsFor all out-of-hours and short-stay patients, children were significantly more likely to be admitted when there was no resident consultant: IRRs 1.07 (95% CI 1.04 to 1.09) and 1.09 (95% CI 1.02 to 1.18), respectively. There was no difference between rates stratified into long stay at night or weekend days: IRRs 1.01 (95% CI 0.96 to 1.07) and 1.03 (95% CI 0.99 to 1.18) respectively .ConclusionA resident consultant presence was associated with reduced total, night-time and short-stay admissions.

scholarly journals Bronchiolitis: Can objective criteria predict eligibility for brief hospitalization?

CJEM ◽  
2003 ◽  
Vol 5 (04) ◽  
pp. 239-244 ◽  
Author(s):  
Lance Brown ◽  
David G. Reiley ◽  
Aaron Jeng ◽  
Steven M. Green
Keyword(s):  
Pulse Oximetry ◽  
Tertiary Care ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Predictor Variables ◽  
Care Hospital ◽  
Short Stay ◽  
Entire Study ◽  
Observation Units ◽  
Syncytial Virus

ABSTRACT Objective: To determine if 3 objective criteria – pulse oximetry, respiratory syncytial virus (RSV) testing, and age – could be used to predict which children hospitalized with bronchiolitis will have brief (&lt;36 hour) hospitalizations and therefore be potential candidates for admission to short-stay observation units. Methods: This was a retrospective medical record review of medically uncomplicated children 3 to 24 months of age with emergency department and hospital discharge diagnoses consistent with bronchiolitis who were admitted to a general pediatric ward in our university-based, tertiary care hospital between Jan. 1, 1992, and Nov. 12, 2002. Multiple logistic regression was used to assess the predictor variables. Results: Our study consisted of 225 patients (45% female) with a median age of 7 months (interquartile range [IQR], 4–11 mo; range, 3–22 mo). Median pulse oximetry value was 94% (IQR 91%–96%; range 76%–100%), and 71% of the patients tested positive for RSV. Thirty children (13%) had brief hospitalizations &lt;36 hours, and the median hospital length of stay for the entire study group was 70 hours (IQR 46–108 h; range 6–428 h). None of the 3 predictor variables were independently associated with brief hospitalization. Conclusions: Pulse oximetry, RSV testing and age do not predict which children will have brief hospitalizations and are appropriate candidates for admission to short-stay observation units.

Residents' and Nurses' Perceptions of Difficult-to-Treat Short-Stay Patients

1993 ◽  
Vol 44 (4) ◽  
pp. 352-357 ◽  
Author(s):  
Ruth Gallop ◽  
William Lancee ◽  
Gerald Shugar
Keyword(s):  
Short Stay ◽  
Nurses Perceptions ◽  
Short Stay Patients

scholarly journals Management Team Perceptions of Risks and Strategies for Preventing Falls Among Short-Stay Patients in Nursing Homes

2018 ◽  
Vol 37 (1) ◽  
pp. 76-85 ◽  
Author(s):  
Michael P. Cary ◽  
Rasheeda K. Hall ◽  
Amber L. Anderson ◽  
Andrew Burd ◽  
Eleanor S. McConnell ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Management Team ◽  
Short Stay ◽  
Short Stay Patients

Skin closure of inguinal herniorrhaphy wounds in short-stay patients

1982 ◽  
Vol 69 (6) ◽  
pp. 341-342 ◽  
Author(s):  
D. N. L. Ralphs ◽  
S. R. Cannon ◽  
J. P. Bolton
Keyword(s):  
Skin Closure ◽  
Short Stay ◽  
Inguinal Herniorrhaphy ◽  
Short Stay Patients
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