News Video | Policy | GPs | Hospitals | Medical | Mental Health | Welfare | Search

 


Hospital project frees up bed space


Media Release

Date: 19 December, 2012

Hospital project frees up bed space

A Waikato Hospital initiative looking at long-stay patients is freeing up bed space, lifting elective surgery numbers and getting those “stranded” patients back to their communities.

“We called them stranded patients, but in fact they were long length of stay due to a number of factors that weren’t prevalent in patients with lengths of stay closer to the norm,” says project convener, General and Specialty Surgery nurse manager Karry Durning,

By identifying common markers of long-term patients Waikato Hospital has seen more than 7000 available bed days created for other patients over the past three and a half years.

“As part of the study more than 140 cases of long-stay patients were reviewed and we saw the same barriers to progress appearing in the patients’ journeys over and over again,” says Karry. “We now track and monitor progress on all our patients who stay over 10 days.”

In 2008-09 long-stay patients took up 44,707 bed days (23 per cent) but accounted for only 2 per cent of inpatient throughput. “On average there were 35-40 patients daily in the hospital with a length of stay greater than 21 days. Indirectly, the long length of stay of these patients created throughput constraints at ward level that contributed to elective surgical cancellations and admission delays from the Emergency Department.”

Long-term stay patients now make up 1 per cent of patients and the bed-days used on these patients has been steadily declining now for nearly four years.

The study has found the quality of care decreases, and risk of hospital-acquired infections, skin pressure wounds and falls increases the longer patients stay in hospital.

Karry has also been instrumental in developing an early identification tool which defines the risk indicators for long length of stay patients. There are 24 indicators defined on the tool and if six or more are present at the time the patient is assessed, the risk of long length of stay becomes real. That puts into play a number of processes to ensure the risks are monitored and patient progress is measured and interventions occur to improve patient progress and get better outcomes.

Clinical nurse specialist Angela Mortimore spends half her weekly time on the project and soon the project will bring together senior nurses from other inpatient services and district nursing services to form the core of the team to support progress for these patients.

“We’re also placing quite a bit of focus in supporting the discharge of these people back into the community, or their local district hospital, as soon as they are able to be discharged safely,” Karry says.
“We’re doing that by bringing senior district nurses into the inpatient event and assisting the discharge. We’re able to stream the patient back with equipment, clinical and personal care services that we can deliver in the community setting. Anything that gets these patients back into their own environment quicker is better for them.

“The district nursing service works with Allied Health staff – social workers, occupational therapists, physiotherapists and dietitians, meals on wheels, disability support services – and supports discharge back to the GP setting and other health providers.

“We also recognise that some of these patients already have contact with our district nursing service and occasionally with other services such as disability support, aged care and mental health, so we’re also trying to bring consistency into the long-stay patients’ experience by maintaining the care programmes through the inpatient stay.’’

For Waikato Hospital freeing up those beds has had great benefits.

“We have eliminated cancellations for elective surgeries in General and Specialty Surgery even when we are in the middle of full winter occupancy. We are completing more elective surgeries and seeing more patients through our beds than ever before,” Karry says.

“And we are still making bed day gains.”

The project has a key role in reducing the hospital’s acute care target of no more than six hours in the Emergency Department. “We start the day with empty beds so can pull patients out of ED and critical care,” Karry says.

“It allows us to ring-fence 14 elective short-stay beds where we have guaranteed bed capacity. So we don’t need to cancel any elective surgeries in my service cluster [General and Specialty Surgery] due to bed block.”

Waikato’s work with stranded patients is being looked at by hospitals throughout Australasia. “A number of Australian and New Zealand hospitals are doing this work now but we are the only one taking it this far,” Karry says.

Others involved in the project are nursing director Suzanne Lawes, group manager Mark Spittal, assistant group manager Kevin Harris, group manager rural and community Jill Dibble and a number of resources across Waikato Hospital’s Rural and Community services.

“We have some skilled and talented people from the hospital and community teams working on this and we’re bringing new ways of joining up our services to support this initiative,” Karry says.

ENDS

© Scoop Media

 
 
 
 
 
Culture Headlines | Health Headlines | Education Headlines

 

Eddie Izzard: UK Comedy Legend Returns

Hailed as one of the foremost stand up comedians of his generation. Star of stage and screen. Tireless supporter of charity. Runner. Political campaigner. Fashion Icon... February 2015, Eddie Izzard will bring his massive FORCE MAJEURE world tour to New Zealand with tickets going on sale at 10am on Tuesday 28th October. More>>

Festival Starts 28 Oct: Improv Fest Makes Up New Show

For any other festival, finding out less than two weeks from showtime that half the cast of a programmed show can’t make it to New Zealand would be a nightmare. Instead, the New Zealand Improv Festival Director Jennifer O’Sullivan saw an opportunity ... More>>

NZ Music Awards Finalists: Lorde, Sol3 Mio Top 2014 Tuis Charge

Lorde has taken the music world by storm during the past year and she co-leads the 2014 Tui charge with five finalist spots. Joining her is newcomer family opera trio, Sol3 Mio. They are followed closely by Ladi6 and David Dallas, both up for four awards each. More>>

From 'Luther' Creator: Major New Zealand Crime Series For BBC

Libertine Pictures and writer Neil Cross have teamed up with leading international TV producer Carnival Films to develop a major new crime series set in Rotorua. Libertine will develop the contemporary drama series with Carnival, producer of internationally-acclaimed British period drama Downton Abbey, for the BBC. More>>

ALSO:

Family Statement: Death Of Ewen Gilmour

“Ewen was a much loved and cherished member of our family, he was a larger than life character and by his very nature was kind, generous and always giving of his time to those who asked for his help." More>>

ALSO:

Auckland: St. Jerome's Laneway Festival - Line-Up Announced

Traversing seven cities and three countries, the festival has well and truly settled into its home in each state. From the grassy knolls and towering silos at home in Auckland, to the sparkling backdrop of the Maribyrnong... More>>

Scoop Review Of Books: No Longer An Island

Simon Nathan reviews 'Zealandia: Our Continent Revealed': The idea that New Zealand is part of a large submerged continent is not new... There was renewed interest in the extent of offshore New Zealand from the 1970s onwards with the start of offshore drilling for oil and gas, and this was given impetus by a UN agreement which allowed countries to claim an Extended Continental Shelf (ECS). More>>

Art: Simon Denny Recreates Kim Dotcom’s Personal Effects

Who owns what? How has the internet changed our relation to the world? These are two of the many questions Simon Denny raises in the latest exhibition at the Adam Art Gallery, opening on Saturday 4 October. More>>

ALSO:

Get More From Scoop

 
 

LATEST HEADLINES

 
 
 
 
Health
Search Scoop  
 
 
Powered by Vodafone
NZ independent news