Reducing Hospital Lengths of Stay: A Five-Year Study

Lagoe, Ronald; Abbott, James H.; Littau, Shelly

doi:10.4236/crcm.2021.106020

Cited by 11 publications

(13 citation statements)

References 5 publications

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“…One study found a decreased risk of infection in patients with a decreased length of hospital stay (Odds ratio = 0.44) 48 . There is also available literature reporting the use of programs to shorten hospital stay saving over 6 million dollars in a 5‐year period, considering surgical patients in the United States 49 . All studies presented data that was in agreement with this finding.…”

Section: Discussionmentioning

confidence: 65%

Enhanced recovery after surgery protocols and emergency surgery: a systematic review and meta‐analysis of randomized controlled trials

Mac Curtain,

O'Mahony,

Temperley

et al. 2023

ANZ Journal of Surgery

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BackgroundThis systematic review and meta‐analysis seeks to assess the modified protocols used and patient outcomes when enhanced recovery after surgery (ERAS) protocols are utilized in an emergency setting.MethodsPubMed, MEDLINE, EMBASE and Cochrane Central Registry of Controlled Trials were comprehensively searched until 13 March 2023. The Cochrane Risk of Bias Assessment Tool was used to assess for bias, along with funnel plot asymmetry. We present log risk ratios for dichotomous variables and raw mean differences for continuous variables.ResultsSeven randomized trials were included, comprising 573 patients. Results of the primary outcomes when comparing ERAS to standard care are as follows; withdrawal of nasogastric tube (raw mean difference −1.87 CI: −2.386 to −1.359), time to first liquid diet (raw mean difference −2.56 CI: −3.435 to −1.669), time to first solid diet (raw mean difference −2.35 CI: −2.933 to −1.76), time to first flatus (raw mean difference −2.73 CI: −5.726 to 0.257), time to first stool passed (raw mean difference −1.83 CI: −2.307 to −1.349), time to removal of drains (raw mean difference −3.23 CI: −3.609 to −2.852), time to removal of urinary catheter (raw mean difference −1.57 CI: −3.472 to 0.334), mean pain score (raw mean difference −1.79 CI: −2.222 to −1.351) and length of hospital stay (raw mean difference −3.16 CI: −3.688 to −2.63).ConclusionsThe adoption of ERAS protocols in an emergency surgery setting was observed to enhance patient recovery, while not indicating any statistically significant increase in adverse outcomes.

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Section: Discussionmentioning

confidence: 65%

Enhanced recovery after surgery protocols and emergency surgery: a systematic review and meta‐analysis of randomized controlled trials

Mac Curtain,

O'Mahony,

Temperley

et al. 2023

ANZ Journal of Surgery

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“…Although the determination as to the practical significance of a mean H-LOS reduction of .54 days is an entirely scientific/ medical one, it has been well established that reduction in H-LOS can lead to a reduction in health care costs and improved patient health outcomes. 30 As such, a reduction in H-LOS is a critical advantage of performing an appendectomy compared to keeping patients in the hospital to monitor response to antibiotic therapy alone.…”

Section: Discussionmentioning

confidence: 99%

Comparing Outcomes of Appendectomy Versus Non-operative Antibiotic Therapy for Acute Appendicitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Zagales

Sauder

Selvakumar

et al. 2022

The American Surgeon™

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Background Acute appendicitis is one of the most common etiologies of an acute abdomen in the emergency department and first-line standard surgical care for the condition has recently been reconsidered. We aim to evaluate the effectiveness and outcomes of surgical intervention versus non-operative antibiotic therapy in the treatment of acute appendicitis in adult and pediatric patients. Methods A literature search was conducted using PubMed, Google Scholar, and EMBASE. The search included all studies until January 15th, 2022. Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines were followed for abstracting data and assessing data quality and validity. Data were independently extracted by the authors of the study. Meta-analysis was performed and Cohen’s Q test for heterogeneous effects was performed to determine if fixed or random-effects models were appropriate for use. Results Twelve randomized controlled trials investigating a total of 3703 acute appendicitis patients met inclusion criteria and were included in the meta-analysis. In the systematic review, eleven RCTs demonstrated that appendectomy had improved effectiveness compared to non-operative antibiotic management. The meta-analysis demonstrated that patients undergoing appendectomy had significantly higher treatment effectiveness compared with antibiotics-only treatment (98.4% vs. 73.3%, P < .0001). The meta-analysis did demonstrate a significant .54-day reduction in hospital length of stay for the appendectomy group compared to the non-operative antibiotic therapy group. Conclusions Surgical intervention is associated with increased effectiveness of treatment and reduced in-hospital length of stay among patients with acute appendicitis. Guidelines established by institutions and surgical organizations should indicate appendectomy as the standard and superior treatment option for patients presenting with acute appendicitis.

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“…32 Concurrently, efficiency gains have reduced the need for hospitalisation, hospital length of stay and cost of care. 33 Improved anaesthesia and surgical techniques have increased the capacity for day-case surgery, meaning in-patient admission has become reserved for patients with significant comorbidities and/or surgical complexity, who are at an increased risk of complications. The number and classes of available medications have increased, particularly around anticoagulants, immune modulators and cancer treatments (Table 2).…”

Section: Changes In Hospital Care and Workplace Requirements Since Rr...mentioning

confidence: 99%

Are we deskilling or reskilling our hospital ward clinicians?

Bunch

Jones

Psirides

2023

Internal Medicine Journal

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Reducing Hospital Lengths of Stay: A Five-Year Study

Cited by 11 publications

References 5 publications

Enhanced recovery after surgery protocols and emergency surgery: a systematic review and meta‐analysis of randomized controlled trials

Enhanced recovery after surgery protocols and emergency surgery: a systematic review and meta‐analysis of randomized controlled trials

Comparing Outcomes of Appendectomy Versus Non-operative Antibiotic Therapy for Acute Appendicitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Are we deskilling or reskilling our hospital ward clinicians?

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