A Systematic Review of Criteria-Led Patient Discharge

Lees-Deutsch, Liz; Robinson, Jane

doi:10.1097/ncq.0000000000000356

Cited by 16 publications

(16 citation statements)

References 19 publications

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“…Risk stratification at admission with enhanced monitoring of those more likely to deteriorate is being considered, although there is little empirical evidence to guide that strategy(17). Criteria Led Discharge, a process in which discharge is determined from pre-defined clinical parameters, is also being explored with the aim of expediting discharge from the service(18).…”

Section: Discussionmentioning

confidence: 99%

Virtual health care for community management of patients with COVID-19.

Hutchings

Dearing

Jagers

et al. 2020

Preprint

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Objectives: To describe the implementation and early experience of virtual health care for community management of patients with COVID-19. Design: observational cohort study. Setting: large Australian metropolitan health service with established virtual health care program and remote patient monitoring capability. Participants: patients with COVID-19 living within the health service who can self-isolate safely, do not require immediate admission to an inpatient setting, have no major active comorbid illness and can be managed at home or other suitable accommodation. Main outcome measures: care escalation rates, including hospital admission. Results: between 11-29 March 2020, 162/173 (93.6%) locally diagnosed patients with COVID-19 were accepted to the virtual health care program, median age 38y (range 11-79). For the 62 patients discharged during this period the median length of stay was 8 days (range 1-17). The peak of 100 prevalent patients equated to approximately 25 patients per Registered Nurse per shift. Patients were contacted a median of 16 times (range 1-30) during this period, with video consultations used 66.3% of the time; 132/162 (81.5%) patients were monitored remotely. Care escalation rates were low: ambulance attendance, 5 (3%); ED attendance, 4 (2.5%); hospital admission, 3 (1.9%). There were no deaths. Conclusions: community-based virtual health care is feasible for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian context for pandemic management. Health services implementing virtual health care should anticipate challenges with rapid technology deployments and provide adequate support to resolve them including strategies supporting consumer use of health information technologies.

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Section: Discussionmentioning

confidence: 99%

Virtual health care for community management of patients with COVID-19.

Hutchings

Dearing

Jagers

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Patient flow throughout a hospital has been shown to be adversely affected when inpatient discharge is delayed (1,2,(8)(9)(10). When hospitals are operating at peak capacity, discharge delays impact throughput and patient length of stay and affect the emergency department, intensive care units, and incoming patients awaiting inpatient beds (2,9,11). All of these issues affect the cost of care and therefore become a priority when attempting to maintain a financially stable entity (7).…”

Section: Discussionmentioning

confidence: 99%

Utilizing Process Improvement Methodology to Improve Inpatient Access to MRI

et al. 2019

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“…Benefits of expedited discharge include the ability for patients to recover at home, reduced absences from school or work, and less exposure to nosocomial infections. 19,20 Additionally, if the patient is contributing directly to their admission cost, their financial burden is reduced. 15 Expedited discharge practices benefit health services by increased bed availability and financial savings.…”

Section: What This Paper Addsmentioning

confidence: 99%

Criteria‐led discharge for simple appendicitis in children: A pilot study

Roddis

Ensor

Williamson

et al. 2022

J Paediatrics Child Health

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Aim: Criteria-led discharge (CLD) protocols have been suggested to increase efficiency of discharge from hospital following surgical interventions. Our aim was to assess the feasibility, clinical outcomes and parental satisfaction following the introduction of a pilot CLD for simple appendicitis (SA) in children. Methods: A prospective pilot cohort study was conducted including paediatric patients with SA who were managed with CLD and a control group who were managed with standard discharge procedures. A CLD pro forma was developed, standardising care guidelines and clinical criteria indicators to be met for children to be discharged post-operatively. A post-discharge parent survey was also utilised. The primary outcome measure was post-operative length of stay (pLOS), with secondary outcomes of post-operative complication rates and parental satisfaction. Results: The control group consisted of 31 patients and CLD group 35 patients. There was no difference in the median pLOS (24 [16.7-44.6] vs. 25.3 [19.1-50.1] h, P = 0.3). Furthermore, there were no significant differences on any of the secondary outcomes. Parental confidence with time of discharge was very high in both control (85.7%) and CLD (88.2%) groups (P = 1.0). Conclusion:The introduction of CLD is safe and feasible. Whilst this pilot has not demonstrated a reduction in pLOS, our data suggest that it is well accepted by the parents.

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A Systematic Review of Criteria-Led Patient Discharge

Abstract: The safety, quality, and length of stay for patients discharged through criteria-led discharge are inextricably linked to the process adopted for its implementation.

Cited by 16 publications

References 19 publications

Virtual health care for community management of patients with COVID-19.

Virtual health care for community management of patients with COVID-19.

Utilizing Process Improvement Methodology to Improve Inpatient Access to MRI

Criteria‐led discharge for simple appendicitis in children: A pilot study

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