Introduction of Medical Short Stay Area and Process Reduces Frequency of Delayed Discharge

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Abstract 1

Background Refurbishment of a medical ward included the creation of a short stay area and introduction of rapid discharge procedures for non-complex patients.

Aims To identify why departure from the ward of recovered children is delayed and whether short stay structure/process reduces discharge delay.

Methods Time of discharge, and frequency and cause of delayed ward departure (> 1 hr) were recorded for 186 medical admissions. A 12-bed short stay unit and departure lounge were then created. Short stay documentation and process were introduced for non-complex patients (likely to stay < 48 hr). Diagnosis, length of stay and discharge delays were recorded for 180 admissions one year later.

Results Originally, 3% of patients left the ward between 10pm and 10am. Discharges were delayed (> 1 hr, n = 36/186) by waiting for parents/transport (31%), the ward round (21%) or drugs/paperwork (17%). With short stay area/process, 12/180 of discharges were delayed (p<0.05, Chi-square). 38 short stay admissions (21%) lasted > 48 hr, including 10 bronchiolitic patients.

Conclusion Medical short stay area/process reduces discharge delay for recovered children. Further study should clarify bronchiolitis short stay admission criteria.

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