Reorganisation of an ailing aged care service.

This paper evaluates the impact of reorganisation of geriatric and general medical services in a tertiary referral hospital. The patients involved were predominantly elderly with multiple medical problems. We used an iterative process of bed utilisation review, stakeholder consultation and service remodelling to improve bed management. Reduced length of stay and increased throughput allowed closure of between 22 and 30 beds and generated recurrent cost savings of $900,000 annually. Even under pressure it is possible to describe and evaluate the process of change. Such description and evaluation may help to avoid expensive mistakes.