Impacto de implementación de medidas de gestión hospitalaria para aumentar la eficiencia en la gestión de camas y disminuir la saturación del servicio de urgencias

espanolObjetivo: Analizar el impacto de la implementacion de medidas para reducir el numero de pacientes ubicados en urgencias en espera de cama de hospitalizacion. Metodo: Tipo de estudio: comparativo con un analisis retrospectivo. Se compararon dos periodos: periodo 1 (nov 06-oct 07) y periodo 2 (nov 07-oct 08). Ambito: Hospital de Sant Boi, hospital general de 126 camas, en Sant Boi de L10bregat (Barcelona). Medidas implementadas: disminucion de la estancia prequirurgica, incremento de la cirugia mayor ambulatoria (CMA) y potenciacion del ingreso en una unidad de corta estancia medica (UCE). Variables estudiadas: admisiones en el SUH, ingresos hospitalarios, ingresos de CMA, el numero de dias en que hayal menos 1 paciente pendiente de cama hospitalaria en el SUH a las 8:00 horas, estancia promedio hospitalaria, actividad y estancia promedio en la UCE. Resultados: El total de admisiones en el SUH fue de 57.140 en el periodo 1, Y 71.280 en el periodo 2, con 4.840 (8,4%) Y 5.385 (7,5%) ingresos, respectivamente. La estancia media de hospitalizacion disminuyo de 5,2 dias a 4,5 dias (p Conclusiones: En nuestra experiencia, las medidas de gestion aplicadas fueron eficaces en la disminucion del numero de pacientes pendientes de cama en urgencias. EnglishObjective: To analyze the impact of hospital management measures to reduce the number of patients held in an emergency department while awaiting admission. Methods: Type of study: retrospective, comparing 2 periods, November 2006 to October 2007 and November 2007 to October 2008. Setting: Hospital de Sant Boi, a 126-bed general hospital in Sant Boi de Llobregat in the province of Barcelona. Management measures: decreased presurgical stay, increased use of ambulatory surgical procedures, and increased use of a medical short-stay unit. Variables studied: emergency department admissions, hospital ward admissions, admissions for ambulatory surgical procedures, number of days in which at least 1 patient was in the emergency department at 8 A.M. while waiting for a bed, mean hospital stay, and admissions and average time spent in the short-stay unit. Results: A total of 57140 patients were admitted to the emergency department in the first period and 71280 in the second period; 4840 (8.4%) were admitted to hospital in the first period and 5385 (7.5%) in the second. The average length of stay was 5.19 days in the first period and 4.54 days in the second (P Conclusions: The management measures applied in this case were effective in reducing the number of patients held in the emergency department while waiting for admission.