Burns Specific Estimated Discharge Date Tool Utilising BRANZ Data: development and evaluation
Kathryn Heath1, Brad Schmitt1, 1Royal Adelaide Hospital, Adelaide, SA, Australia
Abstract
With ever increasing pressure on hospitals, estimating a patient’s discharge date (EDD) at admission has become a key component of early discharge planning to manage bed flow and mitigate circumstances leading to a protracted length of stay (LOS). An EDD provides a common goal and timeline to better coordinate patient care, allocate resources and enable patient and families to prepare for discharge.
There is no universally accepted definition for what constitutes a protracted length of stay (LOS), but it generally refers to a LOS that is significantly longer than average for a particular medical condition or procedure¹. Health Round Table data provides peer site LOS comparisons to help track burn unit performance but lacks sufficient detail to estimate an individual patient discharge date. The LOS associated with the Diagnostic Related Group (DRG) and complexity assigned to each inpatient for funding purposes is a poor predictor of discharge date as DRG’s can’t be effectively determined at admission and LOS varies widely between burns patients allocated within a particular DRG.
At the Royal Adelaide Hospital BRANZ data was utilised to develop a LOS tool to help estimate a patient’s discharge date based on burn %TBSA, site and treatment type, and was recently revised to include BTM. The 75th percentile² was chosen as an indicator for delayed discharge and used to further facilitate timely discharge and identify reasons for prolonged LOS. The LOS guide and results from a review of delayed discharges since 2019 will be presented along with possible areas for improvement.
References
1. Ofori-Asenso R, Liew D, Mårtensson J, Jones D. The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia. J Clin Med. 2020 Sep 22;9(9):3055. doi: 10.3390/jcm9093055. PMID: 32971851; PMCID: PMC7564707.
2. Tefera, G.M., Feyisa, B.B., Umeta, G.T. et al. Predictors of prolonged length of hospital stay and in-hospital mortality among adult patients admitted at the surgical ward of Jimma University medical center, Ethiopia: prospective observational study. J of Pharm Policy and Pract 13, 24 (2020). https://doi.org/10.1186/s40545-020-00230-6
Biography
Kathryn Heath is a physiotherapist currently working as an Allied Health Project Manager at the Royal Adelaide Hospital Adult Burns Unit