David Lavilledieu1, Hamouda Abassi2, Gregoire Mercier3, Myriam Guiraud4, Guillaume Du Chaffaut4, Christophe Milesi5, Gilles Cambonie5, Arthur Gavotto6, Eric Jeziorski7, Pascal Amedro8. 1. Pediatric Cardiology and Pulmonology Department, M3C Regional Reference Centre, Montpellier University Hospital, Montpellier, France. 2. Pediatric Cardiology and Pulmonology Department, M3C Regional Reference Centre, Montpellier University Hospital, Montpellier, France; Self-Perceived Health Assessment Research Unit, EA3279, Public Health Department, Aix-Marseille University, Marseille, France. 3. Medico-economic Research Laboratory, UMR 5112, CNRS, University of Montpellier, Department of Epidemiology and Biostatistics, Montpellier University Hospital, Montpellier, France. 4. Hospital Management Department, Montpellier University Hospital, Montpellier, France. 5. Department of Paediatric and Neonatal Intensive Care, Montpellier University Hospital, Montpellier, France. 6. Pediatric Cardiology and Pulmonology Department, M3C Regional Reference Centre, Montpellier University Hospital, Montpellier, France. Electronic address: a-gavotto@chu-montpellier.fr. 7. Department of Paediatrics, Montpellier University Hospital, Montpellier, France. 8. Pediatric Cardiology and Pulmonology Department, M3C Regional Reference Centre, Montpellier University Hospital, Montpellier, France; PHYMEDEXP, University of Montpellier, INSERM, CNRS, Montpellier, France.
Abstract
INTRODUCTION: Acute bronchiolitis epidemics are known to destabilize healthcare structures and stand as a major public health issue. Our tertiary care regional university hospital designed an organizational infrastructure paediatric plan (OIPP) to adapt to bronchiolitis epidemics. This study aimed to assess the impact of the OIPP on the length of stay and quality of care of children hospitalized for bronchiolitis. METHODS: This epidemiological study analyzed data from 2 epidemic seasons before and after the OIPP implementation. The OIPP used a standardized algorithm of patient orientation and a 4-level stratification of care. RESULTS: A total of 1636 children were included in the study, with 718 children before and 918 children after the OIPP implementation. The length of stay significantly decreased after the OIPP implementation, from 5.1±6.8 days to 3.9±3 days (P<0.001). The 30-day readmission for bronchiolitis remained stable (4.6% vs. 3.4%, P=0.2). The net annual patient service revenue increased from 1,292,532 € to 1,545,720 €. CONCLUSION: The implementation of the OIPP resulted in a significant decrease in the average hospital length of stay. This plan improved patients' quality of care while maintained a balanced budget. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT03663660.
INTRODUCTION: Acute bronchiolitis epidemics are known to destabilize healthcare structures and stand as a major public health issue. Our tertiary care regional university hospital designed an organizational infrastructure paediatric plan (OIPP) to adapt to bronchiolitis epidemics. This study aimed to assess the impact of the OIPP on the length of stay and quality of care of children hospitalized for bronchiolitis. METHODS: This epidemiological study analyzed data from 2 epidemic seasons before and after the OIPP implementation. The OIPP used a standardized algorithm of patient orientation and a 4-level stratification of care. RESULTS: A total of 1636 children were included in the study, with 718 children before and 918 children after the OIPP implementation. The length of stay significantly decreased after the OIPP implementation, from 5.1±6.8 days to 3.9±3 days (P<0.001). The 30-day readmission for bronchiolitis remained stable (4.6% vs. 3.4%, P=0.2). The net annual patient service revenue increased from 1,292,532 € to 1,545,720 €. CONCLUSION: The implementation of the OIPP resulted in a significant decrease in the average hospital length of stay. This plan improved patients' quality of care while maintained a balanced budget. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT03663660.
Authors: Pedro J Alcalá Minagorre; Enrique Villalobos Pinto; José Miguel Ramos Fernández; Rosa Rodríguez-Fernández; Miguel Vázquez Ronco; Luis Escosa-García; Juan Ignacio Montiano Jorge; Juan José García García Journal: An Pediatr (Engl Ed) Date: 2020-06-19
Authors: Yaseen M Arabi; Elie Azoulay; Hasan M Al-Dorzi; Jason Phua; Jorge Salluh; Alexandra Binnie; Carol Hodgson; Derek C Angus; Maurizio Cecconi; Bin Du; Rob Fowler; Charles D Gomersall; Peter Horby; Nicole P Juffermans; Jozef Kesecioglu; Ruth M Kleinpell; Flavia R Machado; Greg S Martin; Geert Meyfroidt; Andrew Rhodes; Kathryn Rowan; Jean-François Timsit; Jean-Louis Vincent; Giuseppe Citerio Journal: Intensive Care Med Date: 2021-02-22 Impact factor: 17.440