Establishing an Orthopedic Excess Hospital Days in Acute Care Program
| العنوان: | Establishing an Orthopedic Excess Hospital Days in Acute Care Program |
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| المؤلفون: | S Ryan Greysen, Michele Fang, Frances Mao, Eric Hume |
| المصدر: | J Hosp Med |
| بيانات النشر: | Wiley, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | medicine.medical_specialty, Joint arthroplasty, Leadership and Management, Arthroplasty, Replacement, Hip, Target population, Assessment and Diagnosis, Patient Readmission, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Acute care, Humans, Medicine, Orthopedic Procedures, 030212 general & internal medicine, Arthroplasty, Replacement, Knee, Care Planning, Aged, Retrospective Studies, Original Research, Hospital days, 030222 orthopedics, business.industry, Health Policy, General Medicine, Length of Stay, Patient Discharge, United States, Orthopedic surgery, Emergency medicine, Female, Fundamentals and skills, Continuity of care, Level of care, business, Service line, Program Evaluation |
| الوصف: | BACKGROUND: Excess days in acute care (EDAC) after total joint arthroplasty (TJA) represent a large economic burden. We developed an Orthopedic EDAC program that triages TJA patients to the appropriate service line (orthopedic vs medicine) and level of care (observation vs inpatient) on re-presentation. We developed and used evidence-based protocols for the treatment of TJA patients who are rehospitalized. METHODS: We defined Orthopedic EDAC as the length of stay (LOS) during readmission and observation stays. Our target population included TJA and revision TJA patients. Patients between April 2016 and September 2017 and between October 2017 and September 2018 were defined as pre-implementation and postimplementation of the Orthopedic EDAC program, respectively. RESULTS: A total of 2,662 patients underwent TJA and revision TJA during the pre-implementation and postimplementation periods. Twenty-three patients were managed on observation status during the study period. Readmissions decreased from 49 (6.1%) during preimplementation to 37 (2.0%) during post-implementation (P = .004). By design, more rehospitalized patients were on the orthopedic surgery service after implementation of the Orthopedic EDAC program (n = 49; 70%) versus before (n = 22; 35%; P = .028). EDAC LOS decreased from 7.75 days to 4.73 days (P = .005). CONCLUSION: In this single-center, before-after pilot of a novel Orthopedic EDAC program, we demonstrated a reduction in readmissions and Orthopedic EDAC LOS, as well as improved continuity of care for TJA patients on representation. Journal of Hospital Medicine 2020;15:XXXXXX. © 2020 Society of Hospital Medicine |
| تدمد: | 1553-5606 1553-5592 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4e641c89500ca9075b525b994f83e150 https://doi.org/10.12788/jhm.3440 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....4e641c89500ca9075b525b994f83e150 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15535606 15535592 |
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