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Healing Daylight
Published in Lisa Heschong, Visual Delight in Architecture, 2021
Hospitals grew ever larger, and ever more dependent on mechanical ventilation and electric lighting. The concept of hospital design as therapeutic for patients lost favor. The primary concerns in hospital design were for ever greater sanitation and ever greater efficiency. When Ulrich’s early studies showed that patients in rooms with daylight and views recovered faster and so had a shorter stay in the hospital, it immediately got the attention of hospital administrators. By reducing ‘average length of stay,’ hospitals could treat more people for less cost. Looking at a future where hundreds of billions of dollars were planned for new hospital construction within the coming decade, hospital administrators became acutely interested in other ways architectural design might improve their bottom line. They realized that the potential was not only to reduce medical costs and risks, but also improve the quality of care that they delivered, with better patient outcomes, better staff performance, satisfaction and retention, and increased satisfaction of the families who paid the bills. All of these pathways have helped to raise the prominence of research supporting evidence-based healthcare design.
Diagnosis-Related Groups: Are Patients in Jeopardy?
Published in Marilyn Sue Bogner, Human Error in Medicine, 2018
Edwards, Reiley, Morris, and Doody (1991) found that increased discharge planning improved efficiency and decreased length of stay. For example, actions were taken to establish early assessment of patient support systems in the home, to enable family participation in the plan, and to improve interdisciplinary collaboration to avoid duplication and delay of services. Laboratory tests and consultation were a primary target of efficiency strategies. Quicker turnaround in those two areas alone contributed to decreasing the length of stay.
Adult golf cart injuries: A rising hazard off the course
Published in Traffic Injury Prevention, 2023
Kyle Gibson, Timothy J. Stevens, Morgan A. Krause
The overall length of stay (LOS) was evaluated in our study as well, with an average of 6.5 days. As with any significant injury, the LOS was longer in the presence of orthopedic and neurosurgical injuries requiring surgical intervention. Increases in age and preexisting comorbidities increased LOS as well. When isolating the geriatric population, ages 65 and older, there were 14 patients whose combined average length of stay was ten days. This is compared to an average LOS of 3.9 days for patients under the age of 65. With an increase in the length of stay for the geriatric population, there is also an increase in hospitalization costs. The daily cost for an inpatient visit at our institution is $1,343, which is a mean average of the standard acute, intermediate, and intensive care rates. The cost difference between the average length of stay between the geriatric and non-geriatric populations was roughly $8,192. The variable of injury, age, and length of stay can significantly burden geriatric patients and their families. Prolonged length of stay can increase the chances of hospital delirium and other hospital-associated complications of patients involved in golf cart injuries.
Managing the waste of over processing in healthcare using accountability through utilization reviews and information technologies
Published in Quality Management Journal, 2022
John Wallace Gardner, Sarah Childs
ALOS is a key measure of general hospital performance. More specifically, ALOS represents lean concepts of efficiency and flow through hospital service processes. “A hospital’s average length of stay is a key indicator of utilization and is predictive of average resources used by a hospital per patient discharge” (Devaraj, Ow, and Kohli 2013, 186). Reviews of research on lean in healthcare suggest that a common challenge and area of focus in this research is to “improve bed rotation and eliminate wastes in the patient’s flow” (Henrique and Filho 2020, 440). Within appropriate bounds, patients can benefit from shorter ALOS by avoiding longer risk of infections and unnecessary care. Shorter ALOS for patients means less cost to patients and less time away from home, work, and other responsibilities. Shorter ALOS relative to insurer limits can also be more profitable for hospitals under certain reimbursement models. Conversely, providers who treat patients more than is necessary can lengthen the time of patient stays. Patients who stay longer than is needed use additional hospital resources. Hospitals may also receive reduced reimbursement by insurers that use condition-based predictions for length of stay (Shi 1996).
Determinants of the Implementation of Home Evaluations among Patients with Fall-Related Fractures at a Convalescent Rehabilitation Ward in Tokyo: A Cross-Sectional Study
Published in Journal of Aging and Environment, 2022
Rumiko Tsuchiya-Ito, Naoki Kusumoto, Keiko Maruyama-Sakurai, Anna Tamai, Haruko Yokoyama, Ayako Watanabe, Takuya Fujiwara, Takashi Yamanaka
To show the basic characteristics of patients, we illustrated care need levels, the types of fracture, whether they underwent surgery, the types of surgery, and length of stays. Based on care need levels, patients are certified to use long-term care services. It ranged between seven levels: Preventive care need level 1 or 2 and Care need level 1 to 5, with higher levels indicating a greater need. In this study, we used care need levels just before admission, and categorized them into four levels: No certification to be applicable, preventive care need level 1 or 2, care need level 1 or 2, and care need level 3 or 4. The types of fractures were categorized into femoral neck fracture, femoral trochanteric fracture, or spine/pelvis/other parts of lower limbs. The undergoing of surgery was categorized dichotomously (undergoing surgery or not undergoing surgery). The type of surgery was counted only among patients who underwent surgery and was categorized as: a bipolar hip arthroplasty, a short femoral nail (gamma nail type), an open reduction and internal fixation (ORIF), a Hansson pin, a sliding hip screw (compression hip screw type), or others. The length of stay was calculated by the difference between the date of admission to discharge (days).