S Thompkins, S Schaefer, D Toh, C Horwood, C H Thompson
{"title":"Outlier or handover: outcomes for General Medicine inpatients.","authors":"S Thompkins, S Schaefer, D Toh, C Horwood, C H Thompson","doi":"10.1071/AH22242","DOIUrl":null,"url":null,"abstract":"<p><p>Objective Patients admitted from the emergency department may be co-located on the treating team's 'home ward'. If no bed is available, patients may be sent to another ward, where they may remain under the admitting team as an 'outlier'. Conversely, care may be handed over to the team on whose home ward they are located. We conducted a retrospective analysis to understand the impact of outlier status and handovers of care on outcomes for General Medicine inpatients. Methods General Medicine admissions at the Royal Adelaide Hospital between September 2020 and November 2021 were analysed. We examined the rate of hospital-acquired complications, inpatient mortality rate, mortality within 48 h of admission, Relative Stay Index, time of discharge from hospital and rate of adverse events within 28 days of discharge. Results A total of 3109 admissions were analysed. Handovers within 24 h of admission were associated with a longer length of stay. There was a trend towards higher rates of adverse events within 28 days of discharge with handovers of care. Outlier status did not affect any outcome measures. Conclusions Handovers within the first 24 h of admission are associated with longer than expected length of stay.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Health Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1071/AH22242","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective Patients admitted from the emergency department may be co-located on the treating team's 'home ward'. If no bed is available, patients may be sent to another ward, where they may remain under the admitting team as an 'outlier'. Conversely, care may be handed over to the team on whose home ward they are located. We conducted a retrospective analysis to understand the impact of outlier status and handovers of care on outcomes for General Medicine inpatients. Methods General Medicine admissions at the Royal Adelaide Hospital between September 2020 and November 2021 were analysed. We examined the rate of hospital-acquired complications, inpatient mortality rate, mortality within 48 h of admission, Relative Stay Index, time of discharge from hospital and rate of adverse events within 28 days of discharge. Results A total of 3109 admissions were analysed. Handovers within 24 h of admission were associated with a longer length of stay. There was a trend towards higher rates of adverse events within 28 days of discharge with handovers of care. Outlier status did not affect any outcome measures. Conclusions Handovers within the first 24 h of admission are associated with longer than expected length of stay.
期刊介绍:
Australian Health Review is an international, peer-reviewed journal that publishes contributions on all aspects of health policy, management and governance; healthcare delivery systems; workforce; health financing; and other matters of interest to those working in health care. In addition to analyses and commentary, the journal publishes original research from practitioners – managers and clinicians – and reports of breakthrough projects that demonstrate better ways of delivering care. Australian Health Review explores major national and international health issues and questions, enabling health professionals to keep their fingers on the pulse of the nation’s health decisions and to know what the most influential commentators and decision makers are thinking.
Australian Health Review is a valuable resource for managers, policy makers and clinical staff in health organisations, including government departments, hospitals, community centres and aged-care facilities, as well as anyone with an interest in the health industry.
Australian Health Review is published by CSIRO Publishing on behalf of the Australian Healthcare and Hospitals Association.