title: Choosing a model of care for patients in alternate level care: caregiver perspectives with respect to staff injury.
abstract: The population of alternate level care (ALC) patients utilizing acute-care hospital resources inappropriate to their needs is growing. The purpose of this study was to explore how the care of ALC patients was managed at 4 acute-care facilities in the Canadian province of British Columbia and to examine how this care impacts on outcomes of staff injury. Interviews were conducted to identify and characterize the different models of ALC. Injury outcomes for all caregivers were obtained (n = 2,854) and logistic regression conducted to compare staff injuries across ALC models. Injured workers were surveyed regarding their perceptions of injury risk and ALC. Five ALC models were identified: low-mix, high-mix, dedicated ALC units, extended care units, and geriatric assessment units. The risk for caregiver injuries was lowest on dedicated ALC units. These findings suggest that acute-care facilities faced with a growing ALC population should consider creating dedicated ALC units.
authors.affiliation: Department of Healthcare and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, British Columbia V6T 1Z3, Canada. ostry@interchange.ubc.ca
authors.forename: Aleck S
authors.initials: AS
authors.lastname: Ostry
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Tomlin
authors.forename: Yuri
authors.initials: Y
authors.lastname: Cvitkovich
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Ratner
authors.forename: Il Hyeok
authors.initials: IH
authors.lastname: Park
authors.forename: Robert B
authors.initials: RB
authors.lastname: Tate
authors.forename: Annalee
authors.initials: A
authors.lastname: Yassi
mesh_terms: D000041:Absenteeism; D000062:Accidents, Occupational / Q000517:prevention & control / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001955:British Columbia; D002755:Choice Behavior; D005500:Follow-Up Studies; D005851:Geriatric Nursing / Q000458:organization & administration*; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D017770:Lifting / Q000009:adverse effects; D016015:Logistic Models; D016294:Models, Nursing; D017146:Models, Organizational; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D016272:Occupational Health; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D036301:Qualitative Research; D012307:Risk Factors; D011795:Surveys and Questionnaires