title: Preadmission processes may improve length of stay for colorectal surgery.
abstract: BACKGROUND
  The preadmission process (PAP) is known to reduce length of stay prior to surgery, but there are few data on its effects on postoperative stay. The aim of the present study was to test the hypothesis that a PAP may reduce postoperative length of stay as well as the preoperative length of stay.
  
  
  METHODS
  An audit of admission and discharge times for patients having major colorectal surgery was undertaken to determine the impact of the preadmission process at Dandenong Hospital. One hundred and two elective patients were identified over a 12-month period.
  
  
  RESULTS
  The 71 patients admitted through the preadmission process had a 10.7-day average length of stay compared to 18.4 days if the patients were admitted directly by the surgeon. The reduction in length of stay was contributed to by 4 days less preoperatively and 4 days less postoperatively. Thus the benefits from a preadmission service can be realized both at admission and discharge. The nature of this impact of preadmission requires further investigation.
  
  
  CONCLUSIONS
  The PAP will reduce preoperative length of stay. Utilization of a PAP also appears to reduce postoperative length of stay and may reduce postoperative complications. Further investigation is required to determine the exact nature and extent of these PAP benefits.
authors.affiliation: Anaesthetic Department, Dandenong Hospital, Victoria, Australia. j.monangle@southernhealth.org.au
authors.forename: John
authors.initials: J
authors.lastname: Monagle
authors.forename: Bruce
authors.initials: B
authors.lastname: Waxman
authors.forename: Steven
authors.initials: S
authors.lastname: Abourizk
authors.forename: Maryanne
authors.initials: M
authors.lastname: Sparrow
authors.forename: Bill
authors.initials: B
authors.lastname: Shearer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000706:statistics & numerical data; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index