Authors: (including presenting author): :
WAN TW
Affiliation: :
Department of Medicine, Tseung Kwan O Hospital
Introduction: :
Introduction: The Hospital Authority in Hong Kong is facing a great challenge because there are an increased in healthcare burden by the rapid increase in healthcare demand for inpatient services in public hospitals. Ward G of Tseung Kwan O Hospital changed to Rapid Assessment Ward during the Winter surge period from 8/2/2019 to 31/5/2019 with targeted group of patients which aimed to speed up clinical investigation and vital observation, hence decrease the length of hospital stay and increase patient turnover.
Objectives: :
The aims and objectives: This study aimed to examine whether decreased in length of stay result in increased risk of 28-day readmission for hospitalized patients with acute medical illness; and to examine whether there are any associations between short or long length of hospital stay and 28-day readmission.
Methodology: :
Methodology: Rapid Assessment Ward-From the period 8/2/2019 to 31/5/2019, there were total number of 1319 patients were admitted to Ward G. Staff of Admission Office during that period would contact ward G if there were patients waiting to admit medical ward, and they would provide information of the patients to Ward G nurse for screening before admission under inclusion criteria.
Result & Outcome: :
Result: Based on the inclusion criteria, 121 patients out of the total number of 1319 patients were selected in the study. The length of stay ranged from 1 day to 17 days in which the largest proportion of patients with 3 days of hospital stay. The study showed that more than half of the selected patients with 1 to 4 days of hospital stay. Seven doctors were included in this study in which Doctor A and B with clinical experience for more than 2 years, and Doctor E to G with clinical experience for less than 2 years. The average length of stay ranged from 3.87 days to 5.36 days. However, Doctor C and D were excluded from the study as their days of medical round were only 14 days after deducting their vacations, in which the cases were under the care and discharged by substituted doctors.
Conclusion: Compared with Group A (Senior doctors- Doctor A and B) and Group B (Junior doctors- Doctor E, F and G), Group A only got 0.917% (21.222%-20.305%) difference for patients with unplanned readmission between the length of stay for 1-4 days and 5 days or more. However, Group B got 21.734% (37.143%-15.409%) difference for patients with unplanned readmission between the length of stay for 1-4 days and 5 days or more. The result of the study showed that there is no association between the length of stay and 28 days unplanned readmission for doctors with clinical experience more than three years. The percentage of unplanned readmission over total patients under this group were similar. However, the result showed that patients with length of hospital stay more than 5 days having a higher rate of 28 days unplanned readmission for doctors with clinical experience less than three years. They have a higher percentage of unplanned readmission for patients with length of stay more than 5 days under the same inclusion criteria.
