A Waiting List to Go Home: An Analysis of Delayed Discharges From Surgical Beds

Abstract

INTRODUCTION The aim of this paper was to analyse patients who were unable to be discharged from a surgical ward despite being surgically fit to leave.PATIENTS AND METHODS Data were collected on all surgical in-patients on a single day. Patients who were surgically fit for discharge but whose discharge was delayed were identified. Demographic data and reasons for delay were noted.RESULTS Nine of 75 patients (12%) were surgical bed blockers. These patients were more likely to have been admitted as emergencies ( P = 0.035) and were older ( P < 0.01) than the remaining patients. They occupied 35% of the total 'bed-days' of the group as a whole with a median in-patient stay of 41 days compared with 2 days for the other patients. Trust-collected data, based on UK Government guidelines, showed only one surgical delayed discharge patient on the day studied.CONCLUSIONS Due to problems in defining delayed discharge Government figures probably underestimate the true numbers. Lack of intermediate care and social service provision are a major cause of bed blocking.

Delay in discharge and its impact on unnecessary hospital bed occupancy

“…The study has confirmed that the same issues persist, but highlights that it is elderly patients admitted acutely and requiring on-going community care that are greatly affected [14]. …”

Assessment of service delays and impact on bed utilisation in a major teaching hospital

“…A large number of previous studies have looked at the causes of delayed discharges [8,9]. A significant proportion of these have focused on elderly patients, the so called ''at risk'' patient group for delayed discharge [10,11].…”

Delays in discharge of vascular surgical patients: a prospective audit

“…The problem of delays in vascular surgical patients in New Zealand public hospital setting has not been quantified and analysed previously. However, delays in discharge in acute general surgical setting in other countries have been reported by three studies 4–6 . Schwanhaeser et al.…”

“…Benson et al. 6 followed the outcome of all the general surgical inpatients on a single day until discharge. In nine (12%) patients, the discharges were delayed.…”

“…Delay in discharge of patients increases ALOS and, hence, a sensible target to improve bed utilization. Studies on general surgical patients have shown that 12–59% of inpatients have delays in discharge 4–6 . In one study, delays accounted for up to 35% of total acute bed days 6 …”