Дисертації з теми "Length of stay (LOS)"
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1
Drager, Katrina A. "Inpatient psychiatric length of stay and readmission rates." Menomonie, WI : University of Wisconsin--Stout, 2007. http://www.uwstout.edu/lib/thesis/2007/2007dragerk.pdf.
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2
Chapman, Evelyn A. 1929. "Nurse case management and hospital length of stay." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/291813.
Повний текст джерелаАнотація:
The relationship between hospital length of stay (LOS) and Nurse Case Management (NCM), defined as the coordination of care along a continuum of hospital and community, was investigated. Three groups of discharged patients in the Diagnostic Related Groups (DRGs) of the Respiratory and Circulatory Medical Diagnostic Categories (MDCs) were described and compared: those who had NCM pre-hospitalization (n = 43), those who had NCM initiated during hospitalization or shortly afterward (n = 22), and those who had no NCM (n = 50). The NCM pre-hospitalization group was older and more likely to live alone. The non-NCM group had more admissions to Critical care. The NCM pre-hospitalization group entered the hospital with lower acuities. The NCM initiated during hospitalization group had significantly higher LOS than the other two groups. There was no significant relationship between LOS and the number and duration of NCM visits. The findings suggest that (1) NCM subjects were at higher risk due to age and living situation and (2) NCM may be associated with reduced LOS on subsequent admissions.
3
Horrocks, Julie. "Double barrier models for length of stay in hospital." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0003/NQ44767.pdf.
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4
Heartfield, Marie. "Governing recovery : a discourse analysis of hospital stay length /." Connect to thesis, 2002. http://eprints.unimelb.edu.au/archive/00001712.
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5
Haybarker, Brian Dale. "Reducing Emergency Department Length of Stay by System Change." ScholarWorks, 2015. http://scholarworks.waldenu.edu/dissertations/1477.
Повний текст джерелаАнотація:
Emergency departments (ED) are exceeding the Centers for Medicare and Medicaid Services and The Joint Commission's recommended 4-hour door-to-admission and 2-hour door-to-discharge for patients. The purpose of this project was to look for factors that decrease door-to-admission and door-to-discharge times and offer recommendations to the Patient Flow Committee (PFC) at the health care facility that may reduce overcrowding, diversion, and patient boarding. The 7-step Iowa model of evidence-based practice (EBP) was used to concentrate on problem-focused triggers that initiate the need for change. The project focused on decreasing door-to-admission and door-to discharge times: by opening an observation unit run by the ED to decrease door-to-admission and door-to-discharge times, increasing point-of-care testing (POCT) within the ED to decrease patients' door-to-admission and door-to-discharge times, and placing a provider in triage to decrease the number of non-urgent patients seen in the ED. A systematic literature review was conducted to gather evidence-based practices other organizations have implemented to decrease the ED patients' length of stay. Article inclusion was based on those strategies that would best fit the milieu of the ED and would be sustainable. Four themes including guidelines, algorithms, expanded services, and modified processes were identified through comprehensive analysis of pertinent literature. A presentation to the 20 member multidisciplinary PFC team presented changes to the current system that may meet goals of reducing overcrowding, diversion, and patient boarding. Since door-to-admission and door-to-discharge times are reported quarterly to the PFC, members will be able to see the impact of the changes and on decreased times for ED patients.
6
Mahoney, Kayla. "Pediatric anterior cruciate ligament surgeries and length of stay." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12500.
Повний текст джерелаАнотація:
Thesis (M.A.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Objective: To determine the efficiency of nerve blocks in decreasing length of stay and verbal pain scores postoperatively in pediatric and adolescent patients undergoing anterior cruciate ligament (ACL) surgery. Design: A retrospective chart review of approximately 900 patients that underwent ACL surgery at Children's Hospital Boston and Waltham between the years of 2007 and 2010 was conducted. Patients' American Society of Anesthesiologists physical classification system number, weight, gender, birthday, length of stay, verbal pain scores, blocks given and local analgesics within them, complications, Emergency Department visits, graft type, readmission rates, and if the stay was extended or not was collected. Kruskai-Wallis tests were run to test if the control group (those without nerve blocks) and those with nerve blocks had statistically different significances between pain scores and length of stay. Results: Including all patients, the mean length of stay was 22.37 hours with a minimum stay of 3.75 hours and a maximum stay of 103.9 hours. The majority of patients had ASA's of one (77.3%), with a smaller percentage having a score of two (22.2%) and three (0.5%). The most prevalent graft type used was the hamstring tendon autograft (67%). There was a statistically significant difference p less than .001 in the median length of stay between graft types, with the patellar tendon graft having the lowest length of stay. The most common type of block given was the femoral block which was given in 70.5% of cases, followed by the femoral-sciatic (17.2%), femoral/lateral femoral cutaneous (2.3%), femoral catheter (1.7%), fascia iliac (1.7%), femoral block with femoral catheter (0.5%), sciatic block with femoral catheter (0.3%), and femoral-sciatic block with femoral catheter (0.1%). Although there was no statistically significance in pain scores (p value =.940), or in length of stay (p value =0.110) between those who received blocks and those that did not; there was a statistically significant difference in both pain scores, p less than 0.004, and length of stay p less than 0.001 between the types of blocks given. Those who received femoral-sciatic blocks had the shortest median hospital stay (8.76 hours) within the group of patients that received the nerve blocks. Besides there being no statistically significance difference in length of stay between those that received blocks and those that did not, there was also no difference in rates of extended stay between those who received blocks and those that did not (p value =0.171) or between the types of blocks given (p score =0.161). When looking at the local anesthetics used in the blocks those who received ropivacaine had lower median pain scores than those receiving bupivacaine (p value =.025); however, the median length of stay was the same regardless of the anesthetic used (p value =0.518). There was no statistically significant difference in complications between those receiving blocks and those not (p value =0.163) or between block types (p value =0.217). The same is true with ED visits. Conclusions: Although our hypothesis that those who had blocks would have lower pain scores and lengths of stay compared to those not given blocks was proven wrong, the results do lead to the possibility of studies comparing the effectiveness of instead using femoral-sciatic blocks, especially in non-allograft cases. In addition, an extension of this study is currently underway with more controls to see if there is a difference between those given blocks and those who were not in length of stay that was not detected in our study.
7
Ezell, Wandella. "Length of Stay and Reimbursement Rates for Medicare Patients." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/5005.
Повний текст джерелаАнотація:
Medicare reimbursement rates across the United States have varied by as much as 49-130% across healthcare facilities. Geographic adjustments and severity of medical diagnoses attribute to some dissimilarity; however, the source of longer hospitalization and higher re-admission rates among Medicare patients requires financial consistency. The research encompassed (N = 3000) patients with hypertension as the focus for the study because this is a critical group of Medicare patients with a chronic disease that has been identified as a silent killer. The principal goal that drove this research study was to explain the variations in length of stay for Medicare patients with hypertension. The theoretical framework was the epidemiological triad model composed of person, place, and time variables. A secondary data set was acquired from the Healthcare Cost and Utilization Project Nationwide database of the National Inpatient Sample for the duration of 2011 - 2013. A multiple logistic regression analysis was conducted to determine if there was a correlation between length of stay and reimbursement rates for hypertensive Medicare patients. The findings of this research study provided an analytical explanation for the forces that have been driving Medicare patients' LOS, and rate of reimbursement. The research study yielded variations in the rate of reimbursement for a government entity in medical charges by illustrating the utilization of geographic price variations. The findings revealed that the categorical variable LOS and reimbursement rates for Medicare hypertensive patients had a significant correlation, and with higher reimbursement rates that were associated with longer hospital duration. The findings of the research study may inform Medicare decision-makers to eliminate geographic price variation and provide greater consistency in the rate of reimbursement, as well as a uniformity in length of stay across all regions of the United States.
8
Durbin, Janet. "Role of patient severity in predicting length of hospital stay." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq29213.pdf.
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Waller, Glenn R. "Length of stay and recidivism : a study of elderly patients /." Full text available from ProQuest UM Digital Dissertations, 2005. http://0-proquest.umi.com.umiss.lib.olemiss.edu/pqdweb?index=0&did=1260788691&SrchMode=1&sid=10&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1185223236&clientId=22256.
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Guzman, Castillo M. "Modelling patient length of stay in public hospitals in Mexico." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/345554/.
Повний текст джерелаАнотація:
This thesis is concerned with the modelling of patient length of stay in public hospitals in Mexico. Patient length of stay is the most commonly worldwide employed outcome measure for hospital resource consumption and performance monitoring. Most of the hospitals around the world use average length of stay as starting point for resource planning. However average estimates frequently gives non-accurate results due to the high variability of the length of stay data. The reason for such high variability may be attributable to the diversity in the patient population and the environment where the patient is treated. Through a systematic review of the literature on methods and models in the field of calculating and predicting patient length of stay, this research highlights the areas of opportunity and research gap from previous studies and practices, and proposes the use of finite mixture models to approximate the distribution of length of stay. Also, these models are proposed as the foundation of more sophisticated models designed to include the internal and external factors associated with LoS. In this context, the thesis proposes three different approaches to explore such factors: individual-based approach, group-based approach and multilevel group-based approach. These interrelated approaches allow a better understanding of the diversity in the patient population and enable length of stay predictions for individual patients, and for cohorts of patients within and between hospitals. In addition, this research is built and evaluated using data from all types of patients treated at two public hospitals operating in Mexico. It is the consideration of the full case-mix of these healthcare facilities that gives this research its unique nature.
11
Wiggins, Sandra. "Utilization management of acute care services : evaluation of the SWITCH index system." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/28355.
Повний текст джерелаАнотація:
In recent years, concern about the rising costs of health care has prompted the development of programs aimed at reducing utilization of hospital services and facilities while maintaining an acceptable standard of care. One of the major strategies that has emerged in the effort to accomplish these dual objectives, is utilization management. Although there are a number of different approaches, the primary aim of all utilization management programs is to identify and eliminate unnecessary and inappropriate hospital use.
To date, most of the utilization research and program development has taken place in the United States. To a great extent, this effort has focussed on the development and use of norms for utilization based on a breakdown of length of stay data by diagnostic-related groups (DRG's). Canadian interest in this type of approach is reflected in the recent development of data bases defined by case-mix groups (CMG's). However, while continued efforts are being made to refine these schemes, they have been vulnerable to the criticism that they do not provide adequately objective criteria for establishing what constitutes appropriate patterns of hospital use. In addition, because they are based on statistically derived norms, they have been criticized as lacking sufficient clinical relevance to encourage physician support. Since hospital utilization is largely determined by the medical staff, utilization management programs that fail to obtain physician support are unlikely to succeed.
An alternative approach, which appears to be gaining in popularity, involves the formulation of criteria which can be used to determine what constitutes appropriate and necessary hospital use. Essentially, it is argued that by directly identifying the source and nature of misutilization, it should be possible to develop more effective strategies for the resolution of identified problems. The American Appropriateness Evaluation Protocol designed by Gertman & Restuccia (1981) is one of the earliest and most highly tested examples of a criterion-based system. In Canada, interest in this type of approach is more recent and, consequently, little attention has as yet been focussed on the development and use of clinical criteria in utilization review and management.
One exception, however, is the SWITCH Index System. This system, which was developed and implemented in 1984 by the Peace Arch District Hospital (White Rock, B.C.), makes a direct attempt to identify and eliminate days of hospital stay during which no appropriate acute care services are being provided. The criteria used in this system are classified under the headings Signs, Wind, Intramuscular Therapy, Tubes, Consultant, and Hospice. Patients are considered to be appropriately placed in the hospital if, on any given day, at least one of the specified criteria are met. Otherwise they are classified as Off-Index and action is taken to identify the source of the problem and to initiate corrective action.
Since a major objective of the SWITCH system is to identify and eliminate inappropriate use, an observable outcome, if the program is successful, should be a reduction in length of stay. The present study investigated this hypothesis by comparing pre- and post- intervention length of stay trends at the Peace Arch District Hospital. In addition, to take into account any general secular trends in length of stay over time, the Peace Arch length of stay was compared to the length of stay observed for a control group of three peer-group member hospitals. Although data covering the four year period 1982 to 1985, indicated that the length of stay at the Peace Arch District Hospital had been decreasing over time, no component of this general decline could be attributed to the SWITCH Index System. Time series regression analyses failed to detect changes in either the slope or the height of the estimated response curve. However, limitations in the study design do not permit any conclusions regarding the potential effectiveness of this system. Characteristics specific to the Peace Arch District Hospital may have prevented the detection of an effect. In addition, because it is likely that there would be a lag between when the program was implemented and when it might be expected to effect a reduction in length of stay, the follow-up period of eleven months may have been too short for the determination of the program's effectiveness.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
12
Millard, Peter Henry. "Geriatric medicine : a new method of measuring bed usage and a theory for planning." Thesis, St George's, University of London, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.320090.
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Lindqvist, Rikard. "Hospital length of stay : register-based studies on breast-cancer surgery /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-312-4/.
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Wilkes, Victoria Louise. "Predicting length of stay in a male medium secure psychiatric hospital." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/3772/.
Повний текст джерелаАнотація:
This thesis examines factors associated with length of hospital stay for mentally disordered offenders, detained within the medium secure psychiatric estate. Following an introduction, Chapter two presents a systematic literature review examining the current literature on factors that predict length of stay for patients detained in medium secure hospitals. Mixed results were found. There was limited convergence across clinical and forensic variables investigated, but greater consensus on what is not associated with length of stay. The limited research available and inconsistencies found indicates the need for further research. Chapter three comprises an empirical research study, investigating which variables within a population of male mentally disordered offenders predict length of stay within a regional, medium secure psychiatric hospital. Preliminary analyses revealed statistically significant relationships between length of stay and nine variables. Effect sizes were small to medium. Logistic regression revealed a statistically significant relationship between length of stay of two years or more and having a diagnosis of schizophrenic disorder. Chapter four presents a critical review of the Historical, Clinical, Risk–20 Violence Risk Assessment (HCR-20) (Version 2), a widely adopted risk assessment framework utilised within forensic psychiatry and the standardised measure used within the empirical study. The review explores the literature on the reliability and validity of the HCR-20, and considers its strengths and limitations. A discussion of the work presented concludes the thesis.
15
Chung, Eui-chul. "Length of stay, housing consumption and tenure choice : an intertemporal analysis." The Ohio State University, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=osu1272487319.
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16
DiLeo, Jessica, Michaela Johnson-Clague, Jennifer Prze, and Asad Patanwala. "Effect of Blood Glucose in the Emergency Department on Hospital Length of Stay." The University of Arizona, 2013. http://hdl.handle.net/10150/614255.
Повний текст джерелаАнотація:
Class of 2013 AbstractSpecific Aims: The objective of this study is to evaluate the effect of early blood glucose correction in the Emergency Department (ED) on hospital length of stay. Methods: This study has received institutional review board approval. This is a retrospective cohort study conducted in an academic medical institution. Diabetic patients with hyperglycemia in the ED between June 1st, 2011 and June 30th, 2012 were included. Patients were excluded if they were less than 18 or greater than 89 years of age, not admitted, had diabetic ketoacidosis or hyperglycemic hyperosmolar state, treated with insulin for hyperkalemia, trauma patients, or had an initial blood glucose value of 200 mg/dL or less. Patients were categorized into two groups based on blood glucose control achieved within the first 24 hours from triage. The primary outcome of this study was to compare hospital length of stay between the groups. Main Results: A total of 161 patients were included in this study. Baseline demographics between groups were statistically similar with the exception of gender (p=0.635), ethnicity (p = 0.149), and co-morbidities calculated by the Charlson Co-Morbidity Score (p = 0.112). Blood glucose values in the ED did not statistically correlate to hospital length of stay (p = 0.299), however, co-morbidities were predictive of hospital length of stay (p = 0.025). Conclusion: Early correction of blood glucose values in the ED are not associated with hospital length of stay.
17
Khaskina, Yelena. "Using simulation to reduce length of stay in a hospital emergency department." Full text available online (restricted access), 1996. http://images.lib.monash.edu.au/ts/theses/Khaskina.pdf.
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Payne, Kieran. "Predicting patient length of stay and outcome using discrete conditional survival methods." Thesis, Queen's University Belfast, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.579783.
Повний текст джерелаАнотація:
The health and social care service is increasingly being placed under pressure to facilitate the demands of an ageing population in a difficult economic climate .. The need for better planning and resource management through statistical modelling has never been greater. This thesis adds to the current research on modelling patient length of stay and outcome within hospital by further developing the family of discrete conditional survival models. A statistical technique, consisting of a conditional and process component, is used to model length of stay within hospital based on information known on first day of admission. The approach in this thesis categorises patients into cohorts with similar characteristics and based upon this classification, accurately predicts their length of stay in hospital. Three new techniques, classification trees, ADA boosting and random forests are introduced into the family of discrete conditional survival models. The use of Coxian phase-type distributions for representing length of stay is examined and optimised with the development of more efficient expressions of the probability density function. This is validated in application by modelling length of stay of geriatric patients in Northern Ireland hospitals. The structure of the resulting distributions are discussed and compared to previous research. The advances in the discrete conditional survival model are illustrated in a model developed as a tool for predicting infant length of stay within neonatal care. With the development of late onset sepsis, the model classifies infants as both high or low risk and depending upon the classification accurately models their corresponding length of stay. Performance measures are calculated for each model and the advantages of using the techniques considered and compared against standard methods. The approach not only accurately predicts outcome and length of stay but contributes to knowledge. Development and potential integration within a hospital environment are discussed as further work.
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Huebner, Blake James. "Comparing Total Hip Replacement Drug Treatments for Cost and Length of Stay." Thesis, North Dakota State University, 2015. https://hdl.handle.net/10365/27859.
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The objective of this study is to identify the potential effect anticoagulants, spinal blocks, and antifibrinolytics have on overall cost, length of stay, and re-admission rates for total hip replacement patients. We use ordinary least squares regression, multiple comparison testing, logistic regression, and chi square tests to fulfill this objective. The combination of warfarin and enoxaparin is associated with the highest cost and length of stay out of the anticoagulants studied. There is no clear combination of spinal blocks associated with the highest cost and length of stay. Tranexamic acid is associated with a reduction in length of stay and likelihood of receiving a blood transfusion, while not increasing overall cost. No drug combination in any category is associated with a change in re-admission rates.
20
Forcenito, Dolores A. "Relationship between patients length of hospital stay and the institution of DRG's /." Staten Island, N.Y. : [s.n.], 1987. http://library.wagner.edu/theses/nursing/1987/thesis_nur_1987_force_relat.pdf.
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Rowe, Lynn A. "Predictive Factors of Intensive Care Length of Stay in Liver Transplant Recipients." Diss., The University of Arizona, 2014. http://hdl.handle.net/10150/338685.
Повний текст джерелаАнотація:
The purpose of this study was to evaluate liver transplant recipient factors associated with postoperative complications leading to longer intensive care unit (ICU) length of stay which in turn may increase hospital morbidity and mortality. A retrospective, correlational design was developed with a sample of 230 participants. Data were collected for liver transplant recipients over a four-year period (June 2007-December 2011) from the electronic medical record and the transplant database. T test and binary logistic regression were used to assess for the factors predictive of ICU complications, ICU length of stay (LOS), hospital length of stay (HLOS), and overall morbidity and mortality. Data were collected from three time periods: preoperatively, intraoperatively, and postoperatively. The factors identified as statistically significant were cold ischemic time, lowest intraoperative glucose, postoperative four-hour blood urea nitrogen (BUN), Postoperative Day 1 (POD 1) hematocrit, postoperative lowest systolic blood pressure, and fresh frozen plasma (FFP) transfusions. Mortality occurred in 1 recipient in the >9-day ICU stay group, and 7 deaths were noted in the >19-day hospital LOS group. Age of recipients who died was 48-59 (6 males, 2 females), with 7 Caucasian and 1 Other. Comorbidities of these deceased recipients were diabetes and obesity with MELD scores of 18-45. Complications experienced by recipients included: 6 with renal failure, 2 with sepsis, 3 with graft dysfunction, and 1 with cerebral edema. Findings from this study showed factors that impact ICU LOS, HLOS, and mortality, including BUN, glucose, and hematocrit. Implications for practice are that these factors should be closely monitored in the pre-, intra-, and postoperative time periods to reduce risks of complications to transplant recipients. Future research should include further evaluation of the factors associated with poor transplant outcomes, including glucose, continuous renal replacement therapy (CRRT) use, age, and gender. Nurse researchers must continue to strive to understand the pathophysiological mechanism of liver disease to reduce ICU complications ultimately to improve the care and outcomes of liver transplant recipients while reducing ICU LOS and HLOS.
22
Andersson, Olle. "Predicting Patient Length Of Stay at Time of Admission Using Machine Learning." Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-255150.
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This master thesis investigates the possibility of using machine learning methods to predict patient length of stay at the time of admission to a clinical ward from the emergency department. The main aim of this thesis is to provide a comparative analysis of different algorithms and to suggest a suitable model that can be used in a hospital prediction software. The results show that it is possible to achieve a balanced accuracy of 0.72 at the time of admission and of 0.75 at a later stage in the process. The suggested algorithm was Random Forest which combines good accuracy with effective training time, making it suitable for on-line use in a hospital. The study shows that there is a clear potential for the use of machine learning methods for predicting length of stay, but that further improvements have to be made before adaption into the healthcare.Detta masterexamensarbete utforskar möjligheten att använda maskin-inlärning för att förutspå vårdtiden för en patient då denne skrivs in på en vårdavdelning från akutvårds-avdelningen vid ett sjukhus. Huvudmålet för arbetet är att tillhandahålla en jämförelse av olika maskininlärnings-algoritmer och föreslå en algoritm som är lämplig att integrera i en mjukvara på sjukhuset. Resultaten visar att det är möjligt att nå en balanced accuracy på 0.72 vid inskrivningstillfället samt 0.75 vid en senare tidpunkt i vårdprocessen. Den föreslagna algoritmen var Random Forest som kombinerade bra prestanda med effektiv träningstid, något som gör den lämplig för att köras på sjukhuset. Projektet visar att det finns en tydlig potential för att använda maskininlärning för att prediktera vårdtid men att förbättringar krävs innan det kan nå hela vägen in i sjukhuset.
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Siazon, Maria Reina Ventura. "Evaluating the Discharge Process Improvement Initiative in Reducing the Length of Stay." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6949.
Повний текст джерелаАнотація:
Extended hospital length of stay (LOS) causes increased health care costs and incidence of never events, such as hospital-acquired infections, pressure ulcers, and falls, which are not reimbursed by Medicare. This study examined if there would be a statistically significant decrease in the LOS of patients after the implementation of a discharge process improvement initiative (DPII), The model for improvement and small tests of change concept were used to guide the DPII at a hospital in northern California. Sources of data included archival data obtained from the hospital's quality improvement department that showed LOS prior to and after the implementation of the DPII. The LOS for 2015 and 2017 were compared using the t test for independent samples. The LOS in 2015 was longer (M = 4.59, SD = 3.66) than in 2017 (M = 4.09, SD = 3.81), a statistically significant difference, M = 0.50, 95% CI [0.32, 0.67], t (77) = 5.574, p = .005, d = 1.3, showing that the implementation of the DPII led to a reduction in the LOS. This reduction cannot be attributed solely to the DPII because other projects were implemented at the same time, such as the Clinical Decisions Unit and multidisciplinary rounds. Future research could focus on the relationship between reduced LOS and readmission and the degree of collaboration among health care team members. The implications of this study for social change include the potential to lower health care costs and increase patients' awareness of their responsibility for their own health.
24
Clarke, Aileen. "Does shorter length of hospital stay affect health outcome? : an investigation into the medical social psychological and economic effects of shorter length of hospital stay for elective abdominal hysterectomy." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.245384.
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DiRocco, Dianne Boyer. "The effect of critical pathways on length of stay for cerebrovascular accident patients." FIU Digital Commons, 1995. http://digitalcommons.fiu.edu/etd/2823.
Повний текст джерелаАнотація:
The purpose of this study was to (a) determine the effect of a critical pathway on the length of hospital stay for patients diagnosed with cerebrovascular accident, and (b) identify the variances associated with delayed length of stay for patients admitted after the implementation of the critical pathway. The sample included 34 patients (Male = 14; Female = 20) diagnosed with either hemorrhagic cerebrovascular (n = 4) or non-hemorrhagic (n = 30) accidents. The mean age was 68 years. A t-test comparing the length of stay for patients admitted to the hospital before (Mean = 8.59, SD = 4.95) and after the implementation of the critical pathway (Mean = 8.71, SD = 3.18) indicate that the critical pathway did not reduce the length of stay, t(32) = -.08, p > .05. Variances associated with extended length of stay for patients admitted after the implementation of the critical pathway included delays in discharge due to patient (23.5%), placement (17.6%), and provider (11.8%).
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Pennington, Brandy Paige. "The Impact of Prealbumin on Postoperative Length of Stay in Elderly Orthopedic Patients." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etd/1019.
Повний текст джерелаАнотація:
The purpose of this research was to evaluate whether serum prealbumin levels would serve as a predictor of hospital length of stay for elderly orthopedic patients who underwent hip replacement surgery. The study consisted of a set of 54 patients admitted to a hospital in Bristol, Tennessee. Patients with depleted prealbumin levels, low to low/normal prealbumin levels, or normal prealbumin levels were analyzed. Data collected from a retrospective chart review included: age, length of stay, serum glucose, sodium, potassium, hematocrit, hemoglobin, BUN, creatinine, WBC, prealbumin, and post operative diet consumption. Data were analyzed using analysis of variance for treatment effects. Because of the limited size of the data set, probabilities approaching p<0.10 were considered and levels of p<0.05 were considered significant. The research failed to show a significant relationship between prealbumin levels at admission and length of patient stay during post-operative recovery.
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Dilworth, Joyce Carroll. "The relationship of nutritional status to unreimbursable costs and length of hospital stay." CSUSB ScholarWorks, 1992. https://scholarworks.lib.csusb.edu/etd-project/721.
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Messer, Lori L. "Infant-Driven Feeding vs. Scheduled Feeding: The Effect on Hospital Length of Stay." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2094.
Повний текст джерелаАнотація:
Developmental delays related to feeding dysfunction in premature infants can lead to lengthy hospitalizations and increased healthcare costs initially and throughout the first year of the child's life. The purpose of this project was to use readiness-to-feed assessments to evaluate the impact of an infant-driven feeding protocol on length of stay. The project compared the length of stay of 2 groups of infants: a demand fed according to a readiness-to-feed protocol (protocol group, n = 14) and a traditionally fed according to scheduled, volume-driven feedings (traditional group, n = 15). The logic model served as the change management framework and synactive theory of infant development provided the theoretical framework. According to Als' synactive theory, a shortened hospital stay for premature infants may reduce adverse effects related to neurosensory development, delayed bonding, and a distant parenting experience. A quantitative research design was used, and data were collected through a retrospective chart review of the 2 groups. Descriptive statistics and analysis of variance were completed. The findings indicated that the length of stay in the protocol group was less than the length of stay in the traditionally fed group and that the difference was statistically significant (p = 0.03). Social change benefits related to the project include improved family bonding, improved neurosensory development of infants, and a reduction in healthcare costs as a result of a shortened length of stay. The findings of this project demonstrated that by using the readiness-to-feed protocol, neonatal intensive care nurses can decrease lengths of stay and costs of hospitalization while reducing adverse effects of traditional care on infant development and bonding.
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Walding, Christina L. "Inappropriate hospital admission and length of inpatient stay : patients with long term neurological conditions." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/28918/.
Повний текст джерелаАнотація:
Introduction Studies have shown that a proportion of patients admitted to hospital do not require the intensity of services they provide. Also, the admission of patients can be for an inappropriate duration. Methods Three studies were conducted. The first study was a record review to determine the appropriateness of patient admissions and inpatient stays. The second examined the wider causes of inappropriate admissions/inpatient stays as perceived by clinicians, and identified interventions to reduce such admissions/stays. Data were collected using focus groups. The final study explored barriers to service use from the perspectives of clinicians and patients. Data were collected from clinicians via an online questionnaire and from both clinicians and patients using semi structured in-depth interviews. Results Of 119 patients, 32 were admitted inappropriately and 83 were admitted for an inappropriate duration. Risk factors for an inappropriate admission included living in the community compared to a nursing/residential home, and for an inappropriate length of stay included the number of presenting complaints, number of long term neurological conditions and whether the participant lived alone in their own home or with others. In the second study, the limited knowledge and a lack of health and social care resources in the community, were perceived as causes of inappropriate admission/lengths of stay. Interventions to prevent inappropriate admissions/lengths of stay included: sub-acute care facilities and patient held summaries of specialist consultations, among others. The final study found that the main barriers to use of services were out of hour's access and unfamiliarity of clinicians with local service provision. Conclusions The causes of inappropriate admissions/lengths of stay related, in main, to communication problems and accessibility of services. Interventions to improve transference of information and knowledge regarding long term condition management and service provision may be warranted.
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Tang, Erin Wei-Man. "The effects of English proficiency on length of stay after isolated cardiac bypass surgery." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/46411.
Повний текст джерелаАнотація:
Nurses often face the challenge of communicating information to patients who may not fully understand English. Limited English proficient (LEP) patients are at higher risk of misunderstanding health teaching, leading to impediments in their recovery. This study examined whether LEP patients have a prolonged length of stay (LOS) following coronary artery bypass graft (CABG) surgery when compared with English proficient (EP) patients. The study also compared the LOS of the two groups of patients (LEP and EP) with the study hospital’s clinical pathway target.
A retrospective chart audit was conducted of all patients undergoing isolated CABG, over a two-year period. A screening tool was administered to determine each patient’s English proficiency based on documented information. A data abstraction tool collected pertinent pre-, intra-, and post-operative health indicators. 691 (97.1%) of the 712 charts reviewed were eligible for inclusion. The “limited or not English proficient” (LEP/NEP) patients had a median post-operative stay that was one day longer than that of the EP patients (7 days versus 6 days, p = .007). The median LOS stay of all patients, irrespective of English proficiency, exceeded the clinical pathway target of 5 days. In an unadjusted polynomial regression model, the LEP/NEP patients were found to be 2.2 times more likely to have a LOS of 9+ days (95% [CI 1.5, 7.2]). The multivariate model revealed that post-operative infection was the strongest predictor of LOS, and language proficiency was no longer statistically significant. Post-operative infections fully mediated the relationship between language proficiency and LOS. Relative to having a < 6-day LOS, patients with infections had greater odds of staying longer: ORadj = 3.30 (95% CI [1.51, 7.19]) for 6 days; ORadj = 4.37 (95 % CI [2.09, 9.14]) for 7-8 days; and ORadj = 12.4 (95% CI [6.03, 25.48]) for 9+ days. Higher infection rates were observed in LEP (29.1%) versus EP patients (16.7%) (OR = 2.05 (95% CI [1.27, 3.30])).
The high infection rates suggest that further research is warranted to examine the mechanisms through which post-operative infections are acquired in CABG patients, and to better understand the role of language proficiency.
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Pinto, Ana Catarina Moreira. "Association between anthropometric indicators of nutritional status and length of stay in hospitalized patients." Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/7361.
Повний текст джерелаАнотація:
Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciada em Ciências da NutriçãoBackground: Undernutrition is highly prevalent in hospitalized patients worldwide and this condition has been associated with increased hospital length of stay (LOS). The diagnosis of undernutrition includes anthropometric measurements. The aim of this study was to measure the independent association of the anthropometric and derived indicators triceps skinfold thickness (TST), mid-upper arm circumference (MUAC), adductor pollicis muscle thickness (APMT), mid-upper arm muscle area (AMA) and mid-upper arm muscle circumference (AMC) with LOS, within a varied group of hospitalized patients. Methods: A total of 695 patients were enrolled in a prospective observational study, conducted in a Portuguese university hospital. Participants were dichotomized for the anthropometric and derived indicators TST, MUAC, APMT, AMA and AMC according to the percentiles 5th and 25th described in the literature, except for APMT, for which only the 5th percentile was used. Cox regression analysis was used to estimate adjusted hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). Results: Patients that presented values lower than the 5th percentile for TST (HR=0.759, 95% CI=0.579;0.995), MUAC (HR=0.822, 95% CI=0.687;0.983), APMT (HR=0.791, 95% CI=0.671;0.933), AMA (HR=0.797, 95% CI=0.660;0.962) and AMC (HR=0.746, 95% CI=0.611;0.911), showed a lower probability of being discharged from the hospital to usual residence over time. For TST (HR 0.798, 95% CI=0.673;0.946), patients whose values were below the 25th percentile also presented a lower probability of being discharged from the hospital to usual residence over time. Conclusion: For all the anthropometric and derived indicators studied, patients that presented values lower than the 5th percentile had a lower probability of being discharged from the hospital to usual residence. For TST, values below the 25th percentile were also associated with lower probability of discharge. Thus, TST was found to be the best anthropometric indicator to predict LOS. This anthropometric indicator can present advantages for the diagnosis of undernutrition since it may allow an earlier detection of a poor nutritional status.
Introdução: A desnutrição apresenta elevada prevalência em doentes hospitalizados e esta condição tem vindo a ser associada com maior tempo de internamento (TI). O diagnóstico da desnutrição inclui indicadores antropométricos. O objetivo deste trabalho foi estudar a associação independente entre os indicadores antropométricos prega cutânea tricipital (PCT), perímetro do meio braço (PB), espessura do músculo adutor do polegar (AP), área muscular do braço (AMB) e perímetro muscular do braço (PMB) e o TI em doentes hospitalizados. Métodos: 695 indivíduos participaram num estudo observacional realizado num hospital universitário Português. Os participantes foram dicotomizados para cada indicador antropométrico PCT, PB, AP, AMB e PMB de acordo com os percentis 5 e 25 descritos na literatura, exceto para o AP, para o qual apenas o percentil 5 foi utilizado. Utilizaram--se modelos de regressão de Cox para calcular os hazard ratios (HR) e os intervalos de confiança a 95% (IC 95%) correspondentes. Resultados: Os participantes que apresentaram valores abaixo do percentil 5 para PCT (HR=0,759; IC 95%=0,579;0,995), PB (HR=0,822; IC 95%=0,687;0,983), AP (HR=0,791; IC 95%=0,671;0,933), AMB (HR=0,797; IC 95%=0,660;0,962) e PMB (HR=0,746; IC 95%=0,611;0,911), revelaram uma menor probabilidade de alta para o domicílio. Para a PCT (HR=0,798; IC 95%=0,673;0,946), apresentar valores abaixo do percentil 25 também se associou a uma menor probabilidade de alta para o domicílio. Conclusão: Os participantes que apresentaram valores abaixo do percentil 5 para todos os indicadores antropométricos mostraram uma menor probabilidade de alta domiciliar. Para a PCT, o percentil 25 também foi associado com uma menor probabilidade de alta para o domicílio. A PCT foi então o melhor indicador antropométrico capaz de prever o TI hospitalar. Incluir este indicador antropométrico nos métodos de diagnóstico de desnutrição pode ser uma mais valia por poder detetar mais precocemente um pior estado nutricional.
N/A
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Henry, Nancy D. "Predictors of length of stay among veterans with schizophrenia admitted to VA nursing homes." Diss., Restricted to subscribing institutions, 2008. http://proquest.umi.com/pqdweb?did=1676977521&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Breikss, Dawn M. "The Impact of Length of Stay on Therapeutic Effectiveness of Multidimensional Treatment Foster Care." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5831.
Повний текст джерелаАнотація:
Youth who are placed in the Multidimensional Treatment Foster Care (MTFC) program come from families with multiple risk factors. The MTFC program is based on social learning theory, which posits that youth learn from modeling those in their environment. It is unclear whether motivation for social learning decreases over time. Past research has indicated that there is an efficacious time period for treatment in the MTFC program (6 to 9 months). The purpose of this quantitative study was to examine the behavior effects of remaining in treatment foster care for an extended length of time. This was measured through pre- and posttreatment scores on the Children's Functional Assessment Rating Scale (CFARS) and specific negative behaviors tracked through the Foster Parent Daily Report. Archival data were used for a sample of 34 youth placed in an MTFC program in a northwestern state. The repeated measures ANOVA results demonstrated increased scores on the CFARS from intake to exit date. Regression analysis indicated that the behaviors of arguing and defiance were observed at higher instances for youth in the MTFC program longer than 6 to 9 months. There were no significant findings related to the behavior of destructiveness/vandalism and the length of stay. The implications for social change include social workers being able to move youth out of MTFC sooner. Also, if behaviors are targeted and treated successfully as youth, then there is a decreased likelihood of the youth having negative and criminal behavior as adults.
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Wigwe, Joseph. "Reducing Length of Hospital Stay for Intellectually Disabled Psychiatric Patients with Chronic Medical Problems." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2908.
Повний текст джерелаАнотація:
Length of hospital stay (LOS) is a major indicator for measuring efficient care. Intellectually disabled psychiatric patients (IDPP) with chronic medical problems have longer LOS due to challenges faced by providers in jointly managing both psychiatric and medical problems. The purposes of this study were to understand the significance of LOS for IDPP, create an intervention toolkit to reduce LOS, establish the content validity of the toolkit, and recommend its implementation. The items of the toolkit are pharmacology, somatic, rehabilitation, psychosocial, and monitoring patients' psychiatric and medical symptoms across care domains. The toolkit was created from the constructs of the psychiatric rehabilitation process model to jointly mange psychiatric and medical issues. The project question asked if a universal agreement rating will be achieved to establish content validity of the toolkit. Orem's self-care deficit theory was used to guide this study. Ten experts with experience in the clinical, financial, legal, and psycho-social aspects of IDPP care, were recruited from 5 county facilities and asked to participate in the study. The inclusion criteria focused on the experts' leadership roles in those facilities. The experts answered two online quantitative surveys. Survey 1 asked 9 questions and elicited opinions on LOS issues for IDPP. Survey 2 asked the experts to rate the efficacy of the toolkit to reduce LOS for IDPP. Survey 1 finding showed that 8 of 10 experts agreed that LOS for IDPP needed to be reduced. Survey 2 finding showed a universal agreement toolkit rating of 0.84, indicating the experts' readiness to adopt the toolkit to reduce LOS for IDPP. This study has the potential to promote social change by enhancing interdisciplinary and collaborative use of best care processes in psychiatry to reduce LOS and jointly manage psychiatric and medical problems affecting IDPP.
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Mathew, Saira A. "Length of stay and discharge outcomes among older adults hospitalized with trauma-related fractures." Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/120852/1/Saira_Mathew_Thesis.pdf.
Повний текст джерелаАнотація:
This thesis examined three phases of hospital care among older adults with trauma- related fractures, which were acute hospitalisation for fracture management, subacute hospital rehabilitation and re-presentations to emergency departments, as well as mortality after hospitalization. The factors associated with longer length of stay, discharge to residential aged care, emergency department re-presentations and premature mortality will inform future research and those seeking to improve management of older adults presenting to hospitals with fractures affecting the upper limb, lower limb or axial skeleton.
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Nguyen, Michelle. "An exploratory analysis of factors associated with length of stay following transcatheter aortic valve implantation." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/57943.
Повний текст джерелаАнотація:
Background: Transcatheter aortic valve implantation (TAVI) is a minimally invasive treatment option for higher surgical risk patients with severe symptomatic aortic stenosis (AS) and significant co-existing conditions which may preclude them from surgical valve replacement. Patient characteristics and wait time have been shown to impact length of stay (LOS) in individuals with heart disease; however, these variables have not been extensively evaluated in the TAVI population. Objective: The purpose of this study was to explore factors associated with post-TAVI recovery, as measured by hospital LOS. Method: A retrospective chart review of consecutive patients who underwent TAVI in Vancouver, British Columbia between January 01, 2013 to December 31, 2014 was conducted. Study variables included patient characteristics and wait time. The outcome variable, LOS, was defined as time, in days, from procedure to hospital discharge. Univariate and bivariate analyses were used to select moderately correlated variables for multivariate regression analysis. Results: The study sample consisted of 257 patients, with a mean age of 81.4 years. The median wait time from acceptance to procedure was 36 days, while the median LOS was 3.0 days. Bivariate analysis showed age, living situation, symptom severity, prior surgical aortic valve replacement (SAVR), and prior balloon aortic valvuloplasty (BAV) to be statistically significantly associated with post-TAVI stay in-hospital. The multivariate model revealed that relative to having a LOS of 1 to 2 days, patients who had previously undergone a BAV were 10.7 times more likely to stay 5 days or more (CI [1.16, 98.1]) compared with patients who had not undergone a BAV. No other baseline factors were found to be statistically predictive of prolonged LOS, although odds ratios suggest patients with lower symptom severity and patients who underwent valve-in-valve TAVI were less likely to experience a longer LOS. The model also showed that patients 75 to 79 years of age, with NYHA class III or IV symptoms, and no prior history of an AVR were more likely to follow a standard course of recovery, staying 3 to 4 days, while patients who had a valve-in-valve procedure were more likely to stay 1 to 2 days.Applied Science, Faculty of
Nursing, School of
Graduate
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Cafarella, Nicole. "The effect of hospital characteristics on length of stay and charges for pediatric asthma patients." CONNECT TO ELECTRONIC THESIS, 2008. http://dspace.wrlc.org/handle/1961/4419.
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McFarland, Robert. "African Caribbean people's experience of mental health services and factors moderating length of hospital stay." Thesis, University of Sheffield, 2009. http://etheses.whiterose.ac.uk/6128/.
Повний текст джерелаАнотація:
The literature review was conducted in order to explore African Caribbean communiti.es' perceptions and experiences of mental health services in the UK. A systematic search of electronic databases identified 21 articles. 10 were satisfaction studies, two were national surveys and nine used a qualitative methodology. Experiences were overwhelmingly negative but community services were perceived more positively. Social exclusion was consistently mentioned by community members and service users when asked about their experiences. Conclusions dra\Vn from the satisfaction studies didn't appear to reflect the findings reported in studies using qualitative methodology. Implications for service providers and directions for future research are discussed. The research reports on an epidemiological study examining ethnic differences in length of acute hospital stay for adult inpatients (aged 16-65) in Sheffield. A retrospective analysis of patient records was conducte~ for all admission episodes over a five year period. African Caribbean patients were found to have the greatest length of stay, but these differences were no longer apparent when controlling for diagnosis. Deprivation and unemployment were not found to have a significant effect. The strongest predictors for length of stay were being detained under the Mental Health Act and receiving a diagnosis of schizophrenia. Being single was also consistently associated with greater length of stay across ethnic groups. The study emphasised the heterogeneity of black and ethnic minority groups and the limitations of broad ethnic categorisation.
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Dabelko, Holly Ione. "Individual and environmental factors that influence length of stay in adult day health care programs /." The Ohio State University, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=osu1486402957196876.
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Butt, Muhammad U. "AGGRESSIVE DIURESIS AND SEVERITY-ADJUSTED LENGTH OF HOSPITAL STAY IN ACUTE CONGESTIVE HEART FAILURE PATIENTS." UKnowledge, 2018. https://uknowledge.uky.edu/crd_etds/2.
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To see if aggressive diuresis in first twenty four hours is associated with a comparable number of total days in the hospital as compared to non-aggressive diuresis. In this retrospective cohort study, we compared the length of hospital stay of consecutive patients admitted in one year based on their diuresis during the first twenty-four hours of hospitalization: aggressive diuresis (group 1) i.e. > 2400mL versus non-aggressive diuresis (group 2) i.e. ≤ 2400mL urine output. Patients were excluded if in cardiogenic shock, had creatinine level above 3 mg/dL on admission, or on dialysis. A total of 194 patients were enrolled (29 in group 1 and 165 in group 2 respectively). The Kaplan-Meier estimate of the median cumulative proportion of patients still hospitalized for the group 1 was 4 days and in group 2 was 5 days (log-rank test; P=0.67). In univariate analysis, Cox PH regression showed unadjusted hazard rate of discharge from hospital was slightly higher in group 1 than group 2 but was statistically non-significant (HR=1.08; P=0.70). In multivariate Cox model analysis, creatinine at the time of admission when greater than 1.6mg/dL (P=0.75), LVEF (P= 0.14), total twenty-four hours dose of intravenous Furosemide given (P=0.98) and interaction between Furosemide dose and Creatinine level (P=0.79) were not significant predictor of hospital discharge. Adjusted hazard rate for discharge from hospital was 12% higher in group 1 than group 2 but still statistically non-significant (HR=1.12; P=0.60). Since the length of hospital stay is similar between two groups, we suggest the goal of diuresis to be less than 2400mL in first twenty-four hours to prevent excessive dehydration.
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Lipovich, Carol Jean. "Analysis of Ventilator Associated Pneumonia Patients' Hospital and Intensive Care Charges, Length of Stay and Mortality." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1366228755.
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Albano, Filipa Maria Marques. "Do hospitals react to random demand pressure by early discharges?" Master's thesis, NSBE - UNL, 2012. http://hdl.handle.net/10362/9534.
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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and EconomicsThis project tries to assess whether hospitals react to random demand pressure by discharging patients earlier than expected. As a matter of fact, combining an unpredictable demand for medical services with limited and, to some extent, fixed medical resources, generates strong incentives to discharge patients earlier than expected when demand is high - increasing the risk of readmission and decreasing the benefit from treatment. This work was conducted as a way to determine whether those incentives actually affect discharging decisions. Analysis of Portuguese hospitals data shows that hospital utilization levels at the time of admission, prior to the admission and post admission do have a negative impact over the length of stay in hospital, although this impact is quantitatively irrelevant. More than that, larger utilization levels have a positive impact over the probability of being discharged at certain days of the week, indicating that an early discharges problem may exist.
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Hagen, Leanne. "The Economics of Genetic Disease in a Level IV Neonatal Intensive Care Unit: Diagnostic Approaches and the Cost of Care." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592136819078415.
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Parkman, Sharon E. "The infant undergoing cardiac surgery : can we predict length of stay and presence of complications from age, weight, diagnoses, and type of of surgery? /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/7215.
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Dunavan, Chad. "Care Coordination for Better Outcomes." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3244.
Повний текст джерелаАнотація:
A deficiency of care coordination and delayed discharge planning has contributed to increased lengths of stay for telemetry patients and has pressed staff to discharge patients expeditiously, potentially leading to increased 30-day readmissions. Rushing the discharge process on the day of discharge has resulted in breakdowns in communication and lack of collaboration amongst the health care team of this study, contributing to extended lengths of stay, increased readmissions, and low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) scores. This project highlighted a patient-centered care coordination team approach with 2 clinical registered nurses and a social worker who coordinated the discharge plan with the patients on admission. Discharge planning on admission and daily briefings involving care coordination and bedside staff reduced the length of stay, improved HCAPHS scores, and reduced 30-day readmissions by fostering better communication and collaboration. A 1-group pretest and posttest were utilized to compare data before care coordination and after care coordination. These findings yielded a length of stay reduction of 2.04 days, a 50% reduction in 30-day readmissions, and HCAPHS communication composite scores above the 50th percentile. The care coordination team exposed various programs and community resources that assisted with medications and durable medical equipment and suggested that companionship alleviated potential anxiety post discharge for those financially and socially burdened. The implications of a patient-centered team-based approach to discharge planning on admission eliminated barriers to discharge, improved patient knowledge of disease management, and provided a positive hospital experience.
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Watterson, Kyle A. "Physical Therapy Utilization and Length of Stay among Patients with Low Back Pain in Florida Hospitals." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6978.
Повний текст джерелаАнотація:
Purpose: The purpose of this work was identify key factors associated with inpatient physical therapy utilization and length of stay for patients with low back pain (LBP) in Florida hospitals.
Rationale: Little is known about factors associated with inpatient physical therapy or length of hospitalization for patients with LBP. This group of works identified the key factors associated with inpatient physical therapy and long lengths of hospitalization for this patient population. Since physical therapy and reduced length of stay are known cost-reducers, identifying key factors may represent significant cost savings to the health care system.
Methods: Several mixed method procedures were utilized to examine physical therapy utilization and length of hospitalization between the years of 1992 and 2014. Policy, patient and hospital characteristics, as well as, hospital procedures during a patient’s stay were examined as contributors to either physical therapy utilization or length of hospitalization.
Conclusion: Many factors are associated with inpatient physical therapy utilization and length of stay for patients with LBP in Florida hospitals.
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Sonde, Lars. "Rehabilitation after stroke : effects of length of stay and treatments to facilitate motor recovery after stroke /." Stockholm, 2001. http://diss.kib.ki.se/2001/91-628-4730-9/.
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Dulka, Iryna M. 1953. "Interdisciplinary discharge planning rounds : impact on timing of social work intervention, length of stay and readmission." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=69711.
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This study examined the effect of interdisciplinary discharge planning rounds on timing of social work intervention, length of stay (LOS), and readmission for patients aged 65 and over. Data sources were the medical charts of 449 patients discharged during two corresponding 28 day periods (one before end one after the implementation of rounds) supplemented by Discharge Planning Committee minutes (DPCM) and interviews with four key informants. No significant differences in the timing of social work intervention, LOS, or readmissions were found between the two samples. Qualitative research revealed that essential components were either missing (physician participation), or not uniformly included (family participation) in rounds, and that staff felt that rounds improved communication among the disciplines and contributed to improved efficiency in planning hospital and posthospital services. These findings highlight the need to further study all aspects of the complex discharge planning process to identify factors that would reduce LOS and readmissions.
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Abbi, Revlin. "A Paitent Length of Stay Grouping and Predicting methodology incorporating Gaussian mixture Models and Classification Algorithms." Thesis, University of Westminster, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.500554.
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Gillan, Catherine C. "Using the piecewise exponential distribution to model the length of stay in a manpower planning system." Thesis, University of Ulster, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338317.
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