title: Appropriate admissions to the appropriate unit: a decision tree approach.
abstract: An intermediate care decision tree tool was developed to meet the demand for intermediate care beds. Concurrently, a charging process was developed to support the acuity adaptable model of care, allowing the patient to remain in the same bed from admission to discharge, regardless of level of care required, adjusting nurse-to-patient ratios as acuity changes. Since beginning this pilot, 96% to 100% of the patients admitted to intermediate care from the emergency department met the criteria. Wait time from request to admission was reduced from 5.5 hours to 2.5 hours. A reduction in nursing costs was noted. The average number of patients waiting daily in the emergency department for an intermediate care bed has been reduced by approximately 80%. A significant difference in length of stay was not noted.
authors.affiliation: Patient Care Services, Critical Care, Newark, DE 19713, USA. jmatukaitis@christianacare.org
authors.forename: Joanne
authors.initials: J
authors.lastname: Matukaitis
authors.forename: Paula
authors.initials: P
authors.lastname: Stillman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wykpisz
authors.forename: Edward
authors.initials: E
authors.lastname: Ewen
mesh_terms: D003663:Decision Trees; D004471:Economics, Nursing; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data*; D007380:Intermediate Care Facilities / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay; D010343:Patient Admission / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000191:economics / Q000706:statistics & numerical data; D013997:Time Factors