A multidisciplinary approach to decreasing length of stay in acute care surgery patients

DePesa, Christopher; Hechi, Majed El; McKenzie, Rachael; Waak, Karen; Woodis, Leslie; Chang, Yuchiao; Gervasini, Alice; Velmahos, George C.; Kaafarani, Haytham M.A.

doi:10.1111/jan.14335

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…We cannot overstate the benefit of trauma service CMs and SWs to facilitate patient discharge planning as part of a multidisciplinary team. 25 They navigate the non-clinical issues and interface with the skilled nursing facilities (SNFs), acute rehabilitation units (ARUs) and acute care facilities to which we transfer a large percentage of patients, and nearly half of the OLDER group. Indeed, as shown in figure 4 , the LOS of the OLDER group does not relate directly to ISS, but is consistent with the many non-clinical factors known to impact their discharge disposition.…”

Section: Discussionmentioning

confidence: 99%

Improving length of stay on a trauma service

Biffl

Lü

Schultz

et al. 2021

Trauma Surg Acute Care Open

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BackgroundReducing length of stay (LOS) is a major healthcare initiative. While LOS is closely linked to the diagnosis and procedure in elective surgery, many additional factors influence LOS on a trauma service. We hypothesized that more standardized patient management would lead to decreased LOS.MethodsRetrospective analysis of Trauma Registry data compared LOS before (PRE) and after (POST) implementation of standardized processes on a trauma service. Patients were subdivided by age (over and under 65 years). Data were compared using unpaired t-test, χ2 test and analysis of variance tests, where appropriate.Results1613 PRE and 1590 POST patients were compared. Although age and Injury Severity Score were similar, median LOS decreased by 1 day for the group overall (p<0.0001), and for subgroups over and under the age of 65 years (p<0.0001). Older patients were discharged home 13% more often in POST, compared with 4% more for younger patients.ConclusionsImproved standardization of processes on a trauma service reduced LOS in patients of all ages. A prospective study may identify specific factors associated with prolonged LOS, to allow further improvement.Level of evidenceIII.Study typeTherapeutic/Care management.

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Section: Discussionmentioning

confidence: 99%

Improving length of stay on a trauma service

Biffl

Lü

Schultz

et al. 2021

Trauma Surg Acute Care Open

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Socioeconomic and clinical factors associated with prolonged hospital length of stay after traumatic brain injury

Yue

Krishnan

Chyall

et al. 2023

Injury

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The Effect of Hospital-to-Home Discharge Interventions on Reducing Unplanned Hospital Readmissions: A Systematic Review and Meta-analysis

Demir Avcı,

Gözüm,

Karadag

2024

Quality Management in Health Care

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Background and Objectives: Unplanned hospital readmissions (UHRs) constitute a persistent health concern worldwide. A high level of UHRs imposes a burden on individuals, their families, and health care system budgets. This systematic review and meta-analysis aimed to evaluate the effectiveness of discharge interventions in the transition from hospital to home in the context of reducing UHRs. Methods: The study design was a meta-analysis of randomized and nonrandomized controlled trials. Eight databases were searched. The effect on UHR rates (odds ratio [OR]) of discharge interventions in the transition from hospital to home was calculated at a 95% confidence interval (95% CI) based on meta-regression and meta-analysis of random-effects models. Results: Results showed that discharge interventions were effective in reducing rehospitalizations (effectiveness/OR =1.39; 95% CI, 1.24-1.55). It was furthermore determined that the studies showed heterogeneous characteristics (P ≤ .001, Q = 50.083, I 2 = 44.093; df = 28). According to Duval and Tweedie's trim and fill results, there was no publication bias. Interventions in which telephone communications and hospital visits (OR = 1.64; 95% CI, 1.25-2.16; P < .001) were applied together were effective among patients with cardiovascular diseases (OR = 1.54; 95% CI, 1.28-2.09; P < .001), and it was found that UHRs were reduced within a period of 90 days (OR = 1.68; 95% CI, 1.16-2.42; P < .001). It was also found that discharge interventions applied to transitions from hospital to home had a diminishing effect on UHRs as the publication dates of the reviewed studies advanced from the past to the present (OR = 0.015; 95% CI, 0.002-0.003; P < .001). Conclusion: Supporting and facilitating cooperation between health care professionals and families should be a key focus of discharge interventions.

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A multidisciplinary approach to decreasing length of stay in acute care surgery patients

Cited by 4 publications

References 15 publications

Improving length of stay on a trauma service

Improving length of stay on a trauma service

Socioeconomic and clinical factors associated with prolonged hospital length of stay after traumatic brain injury

The Effect of Hospital-to-Home Discharge Interventions on Reducing Unplanned Hospital Readmissions: A Systematic Review and Meta-analysis

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