Direct Admission from the Emergency Department to a Subacute Care Ward: An Alternative to Acute Hospitalization
Seng Hock AngBarbara Helen RosarioKo Yen Ivan NgeowXin Yu KohSeruwati Abdul HamidFoo Chin LoiJia XuSubramaniam NagasayiStephen Paul WilkinsonHsiang Peng Adrian LeeWai Leng ChowYuan Xin Christine ChenThulasi ChandranChristopher Lien
8
Citation
10
Reference
10
Related Paper
Citation Trend
Keywords:
Acute care
Acute hospital
Community hospital
This study identifies patient risk factors present prior to an acute hospitalization that are associated with occupying acute care beds for non-acute reasons on the 30 th day of a hospitalization. Data from 952 adult patients were obtained, among which 333 (35%) were evaluated as non-acute on their 30 th day. Inability to move in and out of the bed, cognitive impairment, receiving home or community healthcare services prior to hospitalization, unavailable family resources, a secondary diagnosis within the mental and behavioural category, and age ≥75 years were found to increase the risk of occupying acute care beds for non-acute reasons, while patients with a feeding tube were less likely to be non-acute at day 30.
Acute care
Acute hospital
Cite
Citations (4)
Having worked as pharmacists at a long-term acute care hospital, we know that the concept of LTACH is widely misunderstood. Long-term acute care hospitals are not skilled-nursing facilities, acute rehab institutions, or short-term acute care hospitals. LTACHs offer different services from those of the other facilities, and clinical pharmacists who practice at LTACHs are required to have a high level of clinical and critical care skills.
Acute care
Acute hospital
Community practice
Skilled Nursing Facility
Cite
Citations (0)
In order to demonstrate the advantages of the association between an acute hospital and a long-term facility, a study was made comparing the length of the initial acute hospital stay of eventual long-term patients in an associated hospital, and a number of other acute hospitals without such an association. The mean length of acute hospital stay was 24 days less in the associated acute hospital. In order to ensure comparability, the patients were grouped according to reasons for requiring long-term care. In all six groups, there was a significantly decreased length of acute hospital stay in the associated hospital. The reasons for the more efficient bed utilization in the associated hospital are discussed, and it is recommended that all acute hospitals should endeavor to become associated with long-term facilities. New hospitals should be planned so that acute care and chronic care units are combined in the same facility.
Acute care
Acute hospital
Comparability
Cite
Citations (4)
This study aimed to develop and test strategies, and demonstrate the feasibility and desirability of a self-medication program in an acute care hospital setting. Ten patients admitted with an acute exacerbation of their asthma were recruited to test the protocol. Although the use of the protocol was more time-consuming than the previous nurse administered process, patients and staff found it worthwhile. The outcome of the study is a protocol that could be used with a larger sample of patients, in the acute environment.
Acute care
Acute hospital
Cite
Citations (6)
Background and methods: Ensuring appropriate palliative and end-of-life (EOL) care in the acute environment is complex and challenging. The Liverpool Care Pathway (LCP) aims to support staff to provide holistic EOL care utilizing a structured framework to prompt and guide care. We report on the post-implementation findings of a mixed methodology (survey and focus group [FG] forums) study into staff perceptions of EOL care following the pilot implementation of the LCP into two acute wards. Results and conclusions: Study results suggest that within acute settings staff perceive that the LCP improves EOL care overall, assists interdisciplinary communication around death and dying, and that is a useful tool to positively influence decision making and care delivery. Further research into aspects of staff communication, diagnosing dying, changing direction of care, and the physical environment is warranted.
Acute care
End-of-Life Care
Acute hospital
Care pathway
Advance Care Planning
Cite
Citations (31)
Acute care
Acute hospital
Geriatric Care
Geriatric rehabilitation
Cite
Citations (0)
Fall-related sub-acute and non-acute care and rehabilitation-related acute care: what is the impact?
Background Falls are one of the leading causes of injury in older people. Rehabilitation services can assist individuals to improve mobility and function after sustaining a fall-related injury. However, the true impact of fall-related injuries resulting in hospitalisation are often underestimated because of failure to consider sub-acute and non-acute care provided following an acute care episode. Aim To examine fall-related sub-acute and non-acute care and to establish and project the burden of fall-related rehabilitation in acute care to 2020. Method Retrospective review of sub-acute and non-acute records linked to hospital admission and/or emergency department presentations during 2001–2002 to 2008–2009 in New South Wales (NSW), Australia. Analysis of temporal trends and projections to 2020 of rehabilitation-related (ICD-10-AM: Z47, Z48, Z50, Z75.1) acute hospital admissions. Results There were 4317 individuals with a fall-related injury who were admitted to hospital and later admitted for sub-acute and non-acute care; 84% of these were aged 65+ years; 70.4% were female; 27.2% had femur fractures. Total mean FIM scores significantly increased from 78.4 to 94.6 (p<0.0001) between admission and discharge. Fall-related acute rehabilitation episodes are increasing by 9.1% each year for individuals aged 65 years and older and are projected to rise from 18 300 in 2010–11 to 50 000 admissions by 2020. Significance This is the first study to provide a snap-shot of the epidemiological profile of individuals using sub-acute and non-acute care in NSW using linked data. This information can be used to inform resource implications for fall-related sub-acute and non-acute care and acute rehabilitation services.
Acute care
Acute hospital
Cite
Citations (0)
Objectives—To assess the degree of appropriate referral to the accident and emergency (A&E) department following the use of a community alarm where a mobile warden works in conjunction with the community alarm control centre. Methods—611 consecutive calls using community alarms underwent assessment and the appropriateness of referral to the A&E department was considered. Results—Of 542 requests for help 44 patients were transported to the A&E department (8.1%). Twenty nine patients were admitted (5.3%) and 15 patients (2.8%) discharged home from the A&E department after assessment or treatment, or both. Only three patients (0.55%) had been referred to the A&E department inappropriately. Conclusions—This study shows that where a mobile warden works in conjunction with the community alarm control centre the number of inappropriate referrals to the A&E department should be minimal.
Community hospital
Accident and emergency
Cite
Citations (1)