INTRODUCTION: Political initiatives promoting a more efficient emergency admission process have triggered a reorganisation of the Danish health system with a view to creating fewer and larger admission units counting more experienced physicians. At our hospital, a medical admission unit (MAU) was established. We present the effect of this on the length of hospital stay, mortality rates and the number of readmissions for the last year with the previous structure and the first year of the new MAU structure. MATERIAL AND METHODS: We retrospectively extracted data from the hospital databases on two periods: one year before and the first year after establishment of the MAU. RESULTS: After establishment of the MAU, the overall average length of hospital stay was reduced from 4.1 to 3.8 days (p < 0.01). No increase in mortality either in-house or within 30 days after discharge was seen. A substantial reduction (26%) in the overall number of readmissions within 30 days after discharge was observed. CONCLUSION: The establishment of the MAU improved efficacy at the hospital owing to reduction in the length of hospital stay and the number of readmissions. As judged from mortality rates and indicated by readmission rates, neither the quality of treatment nor patient safety was compromised in a setup, where patients with suspected cardiac diseases are admitted along with patients suspected to suffer from other internal medical diseases. The dynamics between multidisciplinary physicians and nurses seems to improve when they are working close to each other in a setting where team spirit evolves. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.
INTRODUCTION: Political initiatives promoting a more efficient emergency admission process have triggered a reorganisation of the Danish health system with a view to creating fewer and larger admission units counting more experienced physicians. At our hospital, a medical admission unit (MAU) was established. We present the effect of this on the length of hospital stay, mortality rates and the number of readmissions for the last year with the previous structure and the first year of the new MAU structure. MATERIAL AND METHODS: We retrospectively extracted data from the hospital databases on two periods: one year before and the first year after establishment of the MAU. RESULTS: After establishment of the MAU, the overall average length of hospital stay was reduced from 4.1 to 3.8 days (p < 0.01). No increase in mortality either in-house or within 30 days after discharge was seen. A substantial reduction (26%) in the overall number of readmissions within 30 days after discharge was observed. CONCLUSION: The establishment of the MAU improved efficacy at the hospital owing to reduction in the length of hospital stay and the number of readmissions. As judged from mortality rates and indicated by readmission rates, neither the quality of treatment nor patient safety was compromised in a setup, where patients with suspected cardiac diseases are admitted along with patients suspected to suffer from other internal medical diseases. The dynamics between multidisciplinary physicians and nurses seems to improve when they are working close to each other in a setting where team spirit evolves. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.
Authors: Kåre Melchior Hansen; Henrik Nielsen; Betina Vest-Hansen; Anders Møllekær; Reimar Wernich Thomsen; Ole Mølgaard; Hans Kirkegaard; Elisabeth Svensson Journal: BMC Health Serv Res Date: 2017-03-16 Impact factor: 2.655
Authors: Lindsay E M Reid; Ursula Pretsch; Michael C Jones; Nazir I Lone; Christopher J Weir; Zoe Morrison Journal: PLoS One Date: 2018-10-03 Impact factor: 3.240