Length of stay in community hospitals.
OBJECTIVE
To identify the factors that contribute to variation in length of stay in hospital.


METHODS
After a pilot study, an audit was undertaken in 11 community hospitals in a single trust over an eight-week period. Each ward was audited once. During the audit period 202 patients' records were reviewed, of which 71 were GP admissions and 131 were consultant admissions.


RESULTS
Patients admitted to community hospitals were older, predominantly female, classed as at risk of malnutrition and had a reduced functional capacity. An increased length of stay could also be due to limited evidence of discharge planning on transfer from acute or residential homes, a lack of information about patients' social circumstances and how the discharge process was progressed, delay from referral to assessment by the multidisciplinary team, and pressure ulcers on admission to hospital.


CONCLUSIONS
Recommendations for practice are: improved documentation, including an integrated discharge care pathway that is transferable across health and social care; multidisciplinary records; clinical leadership; adapting the current audit tool; and undertaking another audit after the recommendations have been implemented.
Brooks
N
N
De Montfort University, Leicester/Leicestershire.
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team; D010351:Patient Discharge / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D013038:Specialization; D013222:State Medicine; D006113:United Kingdom