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https://hdl.handle.net/2440/65192
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Type: | Journal article |
Title: | Outcomes of establishing an acute assessment unit in the general medical service of a tertiary teaching hospital |
Author: | Li, J. Yong, T. Bennett, D. O'Brien, L. Roberts, S. Hakendorf, P. Ben-Tovim, D. Phillips, P. Thompson, C. |
Citation: | Medical Journal of Australia, 2010; 192(7):384-387 |
Publisher: | Australasian Med Publ Co Ltd |
Issue Date: | 2010 |
ISSN: | 0025-729X 1326-5377 |
Statement of Responsibility: | Jordan Y Z Li, Tuck Y Yong, Denise M Bennett, Lauri T O’Brien, Susan Roberts, Paul Hakendorf, David I Ben-Tovim, Paddy A Phillips and Campbell H Thompson |
Abstract: | Objective: To evaluate the impact of an acute assessment unit (AAU) on length of hospital stay (LOS), emergency department (ED) waiting times, direct discharge rate, unplanned readmission rate and all-cause hospital mortality of general medical patients. Design and setting: Retrospective comparison of data for general medical patients admitted to a tertiary teaching hospital in Adelaide, South Australia, before and after the establishment of an AAU (reference years, 2003 [before] and 2006 [after]). Main outcome measures: Mean LOS, ED waiting times and all-cause hospital mortality during calendar years 2003 (pre-establishment) and 2006 (post-establishment). Results: Following the establishment of an AAU, the mean LOS shortened (from 6.8 days in 2003 to 5.7 days in 2006; P < 0.001) despite a 50.5% increase in the number of admissions (from 2652 to 3992). The number of admitted patients waiting in the ED more than 8 hours for a hospital bed decreased (from 28.7% to 17.9%; P < 0.001), as did the number waiting more than 12 hours (from 20.2% to 10.4%; P < 0.001). The rates of unplanned readmission within 7 and 28 days did not change. The all-cause hospital mortality for general medical admissions was 4.6% in 2003 v 3.7% in 2006 (P = 0.056). Conclusion: The establishment of an AAU within the general medical service coincided with decreases in both LOS and ED waiting times, despite a 50% increase in admissions. This structural reform in the process of acute medical care may have contributed to the improvement in these key health care performance indices without compromising the quality of patient care. |
Keywords: | Humans Length of Stay Patient Admission Patient Discharge Mortality Retrospective Studies Aged Middle Aged Hospitals, Teaching Emergency Service, Hospital Hospital Units Appointments and Schedules South Australia Female Male |
Rights: | © The Medical Journal of Australia 2010 |
DOI: | 10.5694/j.1326-5377.2010.tb03560.x |
Published version: | http://www.mja.com.au/public/issues/192_07_050410/li10287_fm.html |
Appears in Collections: | Aurora harvest 5 Medicine publications |
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