Dataset Information

Impact of inpatient Care in Emergency Department on outcomes: a quasi-experimental cohort study.

ABSTRACT:

Background

Hospitals around the world are faced with the issue of boarders in emergency department (ED), patients marked for admission but with no available inpatient bed. Boarder status is known to be associated with delayed inpatient care and suboptimal outcomes. A new care delivery system was developed in our institution where boarders received full inpatient care from a designated medical team, acute medical team (AMT), while still residing at ED. The current study examines the impact of this AMT intervention on patient outcomes.

Methods

We conducted a retrospective quasi-experimental cohort study to analyze outcomes between the AMT intervention and conventional care in a 1250-bed acute care tertiary academic hospital in Singapore. Study participants included patients who received care from the AMT, a matched cohort of patients admitted directly to inpatient wards (non-AMT) and a sample of patients prior to the intervention (pre-AMT group). Primary outcomes were length of hospital stay (LOS), early discharges (within 24 h) and bed placement. Secondary outcomes included unplanned readmissions within 3 months, and patient's bill size. ?2- and Mann-Whitney U tests were used to test for differences between the cohorts on dichotomous and continuous variables respectively.

Results

The sample comprised of 2279 patients (1092 in AMT, 1027 in non-AMT, and 160 in pre-AMT groups). Higher rates of early discharge (without significant differences in the readmission rates) and shorter LOS were noted for the AMT patients. They were also more likely to be admitted into a ward allocated to their discipline and had lower bill size compared to non AMT patients.

Conclusions

The AMT intervention improved patient outcomes and resource utilization. This model was noted to be sustainable and provides a potential solution for hospitals' ED boarders who face a gap in inpatient care during their crucial first few hours of admissions while waiting for an inpatient bed.

SUBMITTER: Lateef A

PROVIDER: S-EPMC5557060 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Publications

Impact of inpatient Care in Emergency Department on outcomes: a quasi-experimental cohort study.

Lateef Aisha A Lee Soo Hoon SH Fisher Dale Andrew DA Goh Wei-Ping WP Han Hui Fen HF Segara Uma Chandra UC Sim Tiong Beng TB Mahadehvan Malcolm M Goh Khean Teik KT Cheah Noel N Lim Aymeric Y T AYT Phan Phillip H PH Merchant Reshma A RA

BMC health services research 20170814 1

<h4>Background</h4>Hospitals around the world are faced with the issue of boarders in emergency department (ED), patients marked for admission but with no available inpatient bed. Boarder status is known to be associated with delayed inpatient care and suboptimal outcomes. A new care delivery system was developed in our institution where boarders received full inpatient care from a designated medical team, acute medical team (AMT), while still residing at ED. The current study examines the impac ...[more]

PMID: 28806942

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Dataset Information

Impact of inpatient Care in Emergency Department on outcomes: a quasi-experimental cohort study.

Background

Methods

Results

Conclusions

Publications

Impact of inpatient Care in Emergency Department on outcomes: a quasi-experimental cohort study.

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