Outlier or handover: outcomes for General Medicine inpatients
S. Thompkins A , S. Schaefer B , D. Toh A , C. Horwood C and C. H. Thompson B *A Central Adelaide Local Health Network, Adelaide, SA, Australia.
B Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.
C Southern Adelaide Local Health Network, Bedford Park, SA, Australia.
Australian Health Review 47(5) 602-606 https://doi.org/10.1071/AH22242
Submitted: 23 November 2022 Accepted: 15 August 2023 Published: 29 August 2023
Abstract
Patients admitted from the emergency department may be co-located on the treating team’s ‘home ward’. If no bed is available, patients may be sent to another ward, where they may remain under the admitting team as an ‘outlier’. Conversely, care may be handed over to the team on whose home ward they are located. We conducted a retrospective analysis to understand the impact of outlier status and handovers of care on outcomes for General Medicine inpatients.
General Medicine admissions at the Royal Adelaide Hospital between September 2020 and November 2021 were analysed. We examined the rate of hospital-acquired complications, inpatient mortality rate, mortality within 48 h of admission, Relative Stay Index, time of discharge from hospital and rate of adverse events within 28 days of discharge.
A total of 3109 admissions were analysed. Handovers within 24 h of admission were associated with a longer length of stay. There was a trend towards higher rates of adverse events within 28 days of discharge with handovers of care. Outlier status did not affect any outcome measures.
Handovers within the first 24 h of admission are associated with longer than expected length of stay.
Keywords: bed availability, clinical pathway, clinical services, emergency department, hospital, model of care, quality and safety.
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