Fast-tracking acute hospital care — from bed crisis to bed crisis

Abstract

We describe here the results of a continuous quality improvement (CQI) project, the Delayed Discharge Project, in a general medicine service in a New Zealand teaching hospital. Average length of stay (ALOS) dropped by 2.6 days (6.5 to 3.9), readmission rates did not rise, costs of service delivery dropped by $2.4 million, patient numbers increased by 145 (2445 to 2590), while bed numbers reduced from 56 to 32 and ward outliers all but disappeared, suggesting success. However, 2 years after the successful cost-saving measures were introduced the new system crashed as a result of additional bed closures and organisational restructures.