Length of stay patterns for patients of an acute care hospital: implications for nutrition and food services

Abstract

Objective: Shortened hospital average length of stay (ALOS) has been used to justify rationalisation of some services, but, by definition, some patients stay for longer than the average. The objective of this study was to explore lengths of stay and proportions of hospital occupied bed-days (OBDs) of those admitted for longer time periods to inform service planning. Methods:The proportion and ALOS of overnight separations at an Australian tertiary hospital were assessed for admissions of up to 4 days and 4 days or more. This was repeated for 7, 14 and 28 days. The proportion of OBD's for each time period was determined. Results: While the proportion of total hospital patients staying for 4, 7, 14 and 28 days or more is relatively small (21.9%, 13.5%, 6.2%, 2.6%, respectively), they represent a large proportion of OBD's (74.9%, 67.2%, 50.8%, 34.2%) with an ALOS of 14.0, 20.3, 33.7, and 54.4 days, respectively. The majority of long-stay patients were in acute care. Conclusion: Substantial proportions of OBD's are due to patients admitted for time periods far greater than reflected by ALOS. Hospitals need to rethink how to optimally accommodate the nutrition and food requirements of the large patient numbers admitted for longer time periods, many of whom are Shortened lengths of stay have been used as the basis for decision making regarding hospital services such as nutrition and food services. [2][3][4] Menu cycles have been shortened, and consequently the variety and nutritional content of menus influenced, on the basis of the ALOS being less than 1 week. 2,4 The purpose of this study was to explore the lengths of stay at a What is known about the topic? Average length of stay is routinely reported for hospitals, but the skewed nature of length of stay conceals the proportion of beds occupied by those staying for extended periods of time. What does this study add?This study quantifies the substantial proportion of acute care bed-days occupied by those hospitalised for weeks or months. What are the implications for practitioners?The authors suggest the need for inpatient services planning that recognises that half of the hospital beds in the tertiary hospital in this study were occupied by people admitted for 2 weeks or more.

Improving food services for elderly, long‐stay patients in Australian hospitals: Adding food fortification, assistance with packaging and feeding assistance

“…Thirdly, more hospitals are offering menus with cycle lengths of one week or less (particularly the larger hospitals). This may be a result of changes to streamline production, and limit human resources and consumables in a bid to save costs 4,6 . This is likely to increase the problems of discontent with menu variety.…”

“…This may be a result of changes to streamline production, and limit human resources and consumables in a bid to save costs. 4,6 This is likely to increase the problems of discontent with menu variety.…”

“…The prevalence of malnutrition in Australian hospitals has been reported to be up to 49%. [1][2][3][4][5][6][7] There are many possible causes and long-stay and elderly patients are particularly vulnerable. [7][8][9][10][11] Malnutrition in the hospitalised elderly is preventable and treatable.…”

Single Session Social Work in Hospitals

“…Many social work graduates from our Bachelor of Social Work program at the University of Newcastle go on to work in hospitals, so we were keen to examine the prevalence of single session social work in hospitals, and the features of these interventions. Although we were aware that brief contacts have always been part of social work in health services, we were also mindful of the considerable social work literature on the shortening of hospital stays and managed care practices that are imposing limitations on social work interventions in hospitals (Davis, Baldrey, Milosevic, & Walsh, 2004;Davis, Milosevic, Baldrey, & Walsh 2005;Dziegielewski & Holliman, 2001;Vivanti & Banks, 2007). We could see that single session work needed to be supported with evidence from research and needed to be included in education and training.…”

Measuring Plate Waste in Hospitals

“…In addition, the diet type, level of nutrition screening and assessment, level of nutrition knowledge of the medical staff, priority given to nutrition over other care demands, the monitoring of intakes, the amount of feeding assistance, and level of encouragement provided can be reviewed with the dietetic team, medical and nursing management. [9][10][11]…”