System to decrease length of stay for vascular surgery

Reed, Taylor; Veith, Frank J.; Gargiulo, Nicholas J.; Timaran, Carlos H.; Ohki, Takao; Lipsitz, Evan C.; Malas, Mahmoud B.; Wain, Reese A.; Suggs, William D.

doi:10.1016/j.jvs.2003.09.015

Cited by 24 publications

(23 citation statements)

References 14 publications

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“… 1 2 5 6 12–16 However, these risk factors can also become foot disease disorders if severe and result in hospitalisation or amputation. 1 2 5 6 12–16 Foot disease disorders and risk factors typically result from chronic conditions, 3 5–9 such as diabetes, 1 2 7–9 11–14 cardiovascular disease, 10 17–19 chronic kidney disease 6 15 20 and cancer. 7 8 21 …”

Section: Introductionmentioning

confidence: 99%

Prevalence of foot disease and risk factors in general inpatient populations: a systematic review and meta-analysis

et al. 2015

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ObjectiveTo systematically review studies reporting the prevalence in general adult inpatient populations of foot disease disorders (foot wounds, foot infections, collective ‘foot disease’) and risk factors (peripheral arterial disease (PAD), peripheral neuropathy (PN), foot deformity).MethodsA systematic review of studies published between 1980 and 2013 was undertaken using electronic databases (MEDLINE, EMBASE and CINAHL). Keywords and synonyms relating to prevalence, inpatients, foot disease disorders and risk factors were used. Studies reporting foot disease or risk factor prevalence data in general inpatient populations were included. Included study's reference lists and citations were searched and experts consulted to identify additional relevant studies. 2 authors, blinded to each other, assessed the methodological quality of included studies. Applicable data were extracted by 1 author and checked by a second author. Prevalence proportions and SEs were calculated for all included studies. Pooled prevalence estimates were calculated using random-effects models where 3 eligible studies were available.ResultsOf the 4972 studies initially identified, 78 studies reporting 84 different cohorts (total 60 231 517 participants) were included. Foot disease prevalence included: foot wounds 0.01–13.5% (70 cohorts), foot infections 0.05–6.4% (7 cohorts), collective foot disease 0.2–11.9% (12 cohorts). Risk factor prevalence included: PAD 0.01–36.0% (10 cohorts), PN 0.003–2.8% (6 cohorts), foot deformity was not reported. Pooled prevalence estimates were only able to be calculated for pressure ulcer-related foot wounds 4.6% (95% CI 3.7% to 5.4%)), diabetes-related foot wounds 2.4% (1.5% to 3.4%), diabetes-related foot infections 3.4% (0.2% to 6.5%), diabetes-related foot disease 4.7% (0.3% to 9.2%). Heterogeneity was high in all pooled estimates (I2=94.2–97.8%, p<0.001).ConclusionsThis review found high heterogeneity, yet suggests foot disease was present in 1 in every 20 inpatients and a major risk factor in 1 in 3 inpatients. These findings are likely an underestimate and more robust studies are required to provide more precise estimates.

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Section: Introductionmentioning

confidence: 99%

Prevalence of foot disease and risk factors in general inpatient populations: a systematic review and meta-analysis

et al. 2015

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“…The argument is that BM is unnecessary when discharge management is a sufficient and more manageable alternative [cf. [19][20][21][22][23][24]. However, discharge management does not balance patient flow nor does it establish a figurative tap to prevent additional patients per time unit from entering the chain when upstream capacity is limited.…”

Section: Introductionmentioning

confidence: 99%

Buffer management to solve bed-blocking in the Netherlands, 2000-2010. Cooperation from an integrated care chain perspective as a key success factor for managing patient flows.

Mur¹,

Govers

2011

Int J Integr Care

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Introduction:Bed-blocking problems in hospitals reflect how difficult and complex it is to move patients smoothly through the chain of care. In the Netherlands, during the first decade of the 21st century, some hospitals attempted to tackle this problem by using an Intermediate Care Department (ICD) as a buffer for bed-blockers. However, research has shown that ICDs do not sufficiently solve the bed-blocking problem and that bed-blocking is often caused by a lack of buffer management.Tool: Buffer management (BM) is a tool that endeavors to balance patient flow in the hospital to nursing home chain of care.Results: Additional research has indicated that the absence of BM is not the result of providers' thinking that BM is unnecessary, unethical or impossible because of unpredictable patient flows. Instead, BM is hampered by a lack of cooperation between care providers. Conclusion:Although stakeholders recognize that cooperation is imperative, they often fail to take the actions necessary to realize cooperation. Our assumption is that this lack of willingness and ability to cooperate is the result of several impeding conditions as well as stakeholders' perceptions of these conditions and the persistence of their current routines, principles and beliefs (RPBs). Discussion:We recommend simultaneously working on improving the conditions and changing stakeholders' perceptions and RPBs.

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“…Video-assisted thoracoscopic surgery typically results in shorter hospital stays and is associated with fewer postoperative complications [6]. Whether complications after discharge are related to increased readmissions is especially poignant because attention has turned to shortened length of stay (LOS) [7,8].…”

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confidence: 99%

National Analysis of Unplanned Readmissions After Thoracoscopic Versus Open Lung Cancer Resection

Bhagat

Bronsert

Ward

et al. 2017

The Annals of Thoracic Surgery

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Open anatomic lung resections for primary lung cancer had nearly twice the complication rate but only a slightly higher readmission rate than thoracoscopic resection. More complications occurred after discharge after thoracoscopic than open resections. Most readmissions occurred within 2 weeks after both thoracoscopic and open resections. Risk-adjusted comparison identified no statistically significant difference in risk of related, unplanned readmission after thoracoscopic versus open resections. Future studies should focus on identification of processes of care to decrease complications and unplanned readmissions after lung cancer resection.

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System to decrease length of stay for vascular surgery

Abstract: A committed LOS officer with major specific daily responsibilities for decreasing LOS and discharging patients resulted in a 31% to 33% decrease in LOS, with important cost savings to the hospital and no negative effect on patient care.

Cited by 24 publications

References 14 publications

Prevalence of foot disease and risk factors in general inpatient populations: a systematic review and meta-analysis

Prevalence of foot disease and risk factors in general inpatient populations: a systematic review and meta-analysis

Buffer management to solve bed-blocking in the Netherlands, 2000-2010. Cooperation from an integrated care chain perspective as a key success factor for managing patient flows.

National Analysis of Unplanned Readmissions After Thoracoscopic Versus Open Lung Cancer Resection

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