De Acuut Chirurgische Unit, een instrument om de ligduur van patiënten te verlagen?
Eijsvoogel, C.F.H., Schep, N.W.L., Peters, R.W., Budding, A.J., Ubbink, D.T., Vermeulen, H.
Voorzitter(s): G.A. Visser, chirurg, Kennemer Gasthuis, Haarlem & M. van Heijl, AIOS Heelkunde, Diakonessenhuis, Utrecht
Locatie(s): Zaal 80/81
Categorie(ën):
Background
The aim of the study was to assess the impact of an acute surgical admission ward on the acute admission and discharge processes and the quality of the care delivered.
Methods
This prospective cohort study was conducted during a period of two months in a tertiary referral university centre. All acute surgical patients were clustered at the acute surgical unit (ASU) and discharged or transferred to specialised departments within 48 hours. Data were compared with a historical reference group admitted in the same period the year before. The primary outcome was total length of stay (LOS). Secondary outcomes were: the impact on emergency department (ED) waiting times, discharges to home within 48 hours, wrong ward admissions, readmissions, mortality and patient satisfaction.
Results
A total of 249 patients were admitted to the ASU during the study period and were compared with 211 patients of the historical reference group. Following introduction of the ASU the total LOS decreased significantly from a median of 4.0 to 2.0 days. The percentage of patients who were discharged within 48 hours increased with 13% to 43%. Wrong ward admissions decreased from 10 to 0% during the study period. In addition, the ED waiting time, readmission rate and 30-day mortality rate did not change. Patient satisfaction surveys gave an overall median satisfaction score of 8 out of 10.
Conclusion
Introduction of an ASU was found to shorten the patients’ LOS without comprising the readmission and mortality rate or patient satisfaction.
- Over Eijsvoogel, C.F.H.
- Over Schep, N.W.L.
- Over Peters, R.W.
- Over Budding, A.J.
- Over Ubbink, D.T.
- Over Vermeulen, H.