A methodology to estimate the potential to move inpatient to one day surgery

Gilliard, Nicolas; Eggli, Yves; Halfon, Patricia

doi:10.1186/1472-6963-6-78

Cited by 13 publications

(9 citation statements)

References 45 publications

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“…2 To determine the potential volume of surgery suitable for HVSS in NSW, all planned surgery diagnostic-related groups (DRGs) were examined. It does not include minor surgery under local anaesthetic conducted in procedure rooms or surgeon's office.…”

Section: Hvss Surgical Servicesmentioning

confidence: 99%

“…It does not include minor surgery under local anaesthetic conducted in procedure rooms or surgeon's office. 2 To determine the potential volume of surgery suitable for HVSS in NSW, all planned surgery diagnostic-related groups (DRGs) were examined. Where 50% or more patients in the DRGs had a length of stay of less than 72 h, these DRGs were considered appropriate for the HVSS model.…”

Section: Hvss Surgical Servicesmentioning

confidence: 99%

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Surgical services: shaping future directions

MacLellan

Smyth

Cregan

et al. 2011

ANZ Journal of Surgery

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Section: Hvss Surgical Servicesmentioning

confidence: 99%

Section: Hvss Surgical Servicesmentioning

confidence: 99%

Surgical services: shaping future directions

MacLellan

Smyth

Cregan

et al. 2011

ANZ Journal of Surgery

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“…Converting as many elective patients requiring treatments and operations as possible into day-only cases receiving care in dedicated day therapy and procedure units. 31 In the UK up to 75% of all elective operations are now performed as dayonly cases 32 compared with current Australian rates of 50%. Increasingly, operations such as laparoscopic cholecystectomy 33 and percutaneous coronary angioplasty 34 can be performed as day-only cases.…”

Section: Functionally Separating Acute and Elective Beds And Servicesmentioning

confidence: 99%

Public hospital bed crisis: too few or too misused?

Scott¹

2010

Aust. Health Review

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*Increasing demand on public hospital beds has led to what many see as a hospital bed crisis requiring substantial increases in bed numbers. By 2050, if current bed use trends persist and as the numbers of frail older patients rise exponentially, a 62% increase in hospital beds will be required to meet expected demand, at a cost almost equal to the entire current Australian healthcare budget. *This article provides an overview of the effectiveness of different strategies for reducing hospital demand that may be viewed as primarily (although not exclusively) targeting the hospital sector -increasing capacity and throughput and reducing readmissions -or the non-hospital sector -facilitating early discharge or reducing presentations and admissions to hospital. Evidence of effectiveness was retrieved from a literature search of randomised trials and observational studies using broad search terms. *The principal findings were as follows: (1) within the hospital sector, throughput could be substantially improved by outsourcing public hospital clinical services to the private sector, undertaking whole-of-hospital reform of care processes and patient flow that address both access and exit block, separating acute from elective beds and services, increasing rates of day-only or short stay admissions, and curtailing ineffective or marginally effective clinical interventions; (2) in regards to the non-hospital sector, potentially the biggest gains in reducing hospital demand will come from improved access to residential care, rehabilitation services, and domiciliary support as patients awaiting such services currently account for 70% of acute hospital bed-days. More widespread use of acute care and advance care planning within residential care facilities and population-based chronic disease management programs can also assist. *This overview concludes that, in reducing hospital bed demand, clinical process redesign within hospitals and capacity enhancement of non-hospital care services and chronic disease management programs are effective strategies that should be considered before investing heavily in creating additional hospital beds devoid of any critical reappraisal of current models of care. What is known about the topic?There is a growing demand for inpatient care in Australia, with presentations to public hospital emergency departments increasing by 4.9% per year over the last 5 years and admission numbers increasing by 3.6% per year. Increasing numbers of hospital beds may give only short-term reprieve in lowering bed occupancy rates if little attention is giving to improving hospital efficiency by internal process redesign or by decreasing demand for acute hospital beds by improving capacity of the non-hospital sector to manage sub-acute illness and chronic disease. What does this paper add? This article provides a narrative meta-review of the evidence of effectiveness of various reform strategies. The key findings are that, within the hospital sector, patient throughput could be substantially improved by:...

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“…Separating acute‐care and elective patient beds and services geographically within hospitals, and moving more patients into dedicated day‐therapy and procedure units, 16 all with separate funding and staffing, have potential in institutions with the procedural volume to do this. However, because the status of patients can change unexpectedly from elective to acute, freestanding, off‐campus ambulatory surgical centres with limited emergency back‐up should treat very selected cases and not compromise the training and efficient deployment of a limited surgical workforce.…”

Section: Increasing Hospital Capacity and Efficiencymentioning

confidence: 99%

The NHHRC final report: view from the hospital sector

Scott

2009

Medical Journal of Australia

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The National Health and Hospitals Reform Commission (NHHRC) report attempts to deal in the short term with hospital access block by funding more beds in emergency departments, while, over the longer term, reforms aim to improve hospital efficiency, transfer care of patients to non‐hospital settings, optimise use of outpatient clinics, fund hospital activities on the basis of efficient cost, and improve governance and accountability. The single most potentially effective recommendation is the considerable investment in and expansion of subacute and non‐acute services, which will free up acute‐care hospital beds for urgent cases. Population‐based chronic disease management driven by Primary Health Care Organisations can also reduce future hospitalisations considerably. What the NHHRC could have dealt with more fully is the need to: (i) prioritise clinical interventions and the need for hospitalisation using evidence of cost‐effectiveness obtained from clinical trials and longitudinal patient data; and (ii) move quickly towards funding of all health care by one level of government. Even the most effective reforms will not have a significant impact on future bed demand if professional and public expectations remain unsustainably high and do not acknowledge the need to change the role of hospitals within a reconfigured health care system.

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A methodology to estimate the potential to move inpatient to one day surgery

Cited by 13 publications

References 45 publications

Surgical services: shaping future directions

Surgical services: shaping future directions

Public hospital bed crisis: too few or too misused?

The NHHRC final report: view from the hospital sector

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