Evaluation of a flexible acute admission unit: Effects on transfers to other hospitals and patient throughput times

Van der Linden, C; Lucas, C; Van der Linden, N; Lindeboom, R

Evaluation of a flexible acute admission unit: Effects on transfers to other hospitals and patient throughput times

Van der Linden, C Lucas, C Van der Linden, N

Lindeboom, R

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Publication Type:: Journal Article
Citation:: Journal of Emergency Nursing, 2013, 39 (4), pp. 340 - 345
Issue Date:: 2013-07-01

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Field	Value	Language
dc.contributor.author	Van der Linden, C	en_US
dc.contributor.author	Lucas, C	en_US
dc.contributor.author	Van der Linden, N https://orcid.org/0000-0003-1646-9834	en_US
dc.contributor.author	Lindeboom, R	en_US
dc.date.available	2011-09-07	en_US
dc.date.issued	2013-07-01	en_US
dc.identifier.citation	Journal of Emergency Nursing, 2013, 39 (4), pp. 340 - 345	en_US
dc.identifier.issn	0099-1767	en_US
dc.identifier.uri	http://hdl.handle.net/10453/116627
dc.description.abstract	Introduction: To prevent overcrowding of the emergency department, a flexible acute admission unit (FAAU) was created, consisting of 15 inpatient regular beds located in different departments. We expected the FAAU to result in fewer transfers to other hospitals and in a lower length of stay (LOS) of patients needing hospital admission. Methods: A before-and-after interventional study was performed in a level 1 trauma center in the Netherlands. Number of transfers and LOS of admitted ED patients in a 4-month period in 2008 (control period) and a 4-month period in 2009 (intervention period) were analyzed. Results: Of 1,619 regular admission patients, 768 were admitted in the control period and 851 in the intervention period. The number of transfers decreased from 80 (10.42%) to 54 (6.35%) (P = .0037). The mean ED LOS of both the non-admitted patients and the admitted patients needing special care significantly increased (105 minutes vs 117 minutes [P = .022] and 176 minutes vs 191 minutes [P < .001], respectively). However, the mean LOS of FAAU-admissible patients was unaltered (226 minutes vs 225 minutes, P = .865). Conclusions: The FAAU reduced the number of transfers of admitted patients to other hospitals. The increase in LOS for special care patients and non-admitted patients was not observed for regular, FAAU-admissible patients. Flexible bed management might be useful in preventing overcrowding. © 2013 Emergency Nurses Association.	en_US
dc.relation.ispartof	Journal of Emergency Nursing	en_US
dc.relation.isbasedon	10.1016/j.jen.2011.09.024	en_US
dc.subject.classification	Nursing	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hospitalization	en_US
dc.subject.mesh	Length of Stay	en_US
dc.subject.mesh	Patient Admission	en_US
dc.subject.mesh	Patient Transfer	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Trauma Centers	en_US
dc.subject.mesh	Efficiency, Organizational	en_US
dc.subject.mesh	Netherlands	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Evaluation of a flexible acute admission unit: Effects on transfers to other hospitals and patient throughput times	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	39	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	39	en_US

Abstract:

Introduction: To prevent overcrowding of the emergency department, a flexible acute admission unit (FAAU) was created, consisting of 15 inpatient regular beds located in different departments. We expected the FAAU to result in fewer transfers to other hospitals and in a lower length of stay (LOS) of patients needing hospital admission. Methods: A before-and-after interventional study was performed in a level 1 trauma center in the Netherlands. Number of transfers and LOS of admitted ED patients in a 4-month period in 2008 (control period) and a 4-month period in 2009 (intervention period) were analyzed. Results: Of 1,619 regular admission patients, 768 were admitted in the control period and 851 in the intervention period. The number of transfers decreased from 80 (10.42%) to 54 (6.35%) (P = .0037). The mean ED LOS of both the non-admitted patients and the admitted patients needing special care significantly increased (105 minutes vs 117 minutes [P = .022] and 176 minutes vs 191 minutes [P < .001], respectively). However, the mean LOS of FAAU-admissible patients was unaltered (226 minutes vs 225 minutes, P = .865). Conclusions: The FAAU reduced the number of transfers of admitted patients to other hospitals. The increase in LOS for special care patients and non-admitted patients was not observed for regular, FAAU-admissible patients. Flexible bed management might be useful in preventing overcrowding. © 2013 Emergency Nurses Association.

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http://hdl.handle.net/10453/116627