Decreased hospital length of stay associated with presentation of cases at morning report with librarian support.
OBJECTIVE
The research sought to determine whether case discussion at residents' morning report (MR), accompanied by a computerized literature search and librarian support, affects hospital charges, length of stay (LOS), and thirty-day readmission rate.


METHODS
This case-control study, conducted from August 2004 to March 2005, compared outcomes for 105 cases presented at MR within 24 hours of admission to 19,210 potential matches, including cases presented at MR and cases not presented at MR. With matching criteria of patient age (+/- 5 years), identical primary diagnosis, and secondary diagnoses (within 3 additional diagnoses) using International Classification of Diseases (ICD-9) codes, 55 cases were matched to 136 controls. Statistical analyses included Student's t tests, chi-squared tests, and nonparametric methods.


RESULTS
LOS differed significantly between matched MR cases and controls (3 days vs. 5 days, P < 0.024). Median total hospital charges were $7,045 for the MR group and $10,663 for the control group. There was no difference in 30-day readmission rate between the 2 groups.


CONCLUSIONS
Presentation of a case at MR, followed by the timely dissemination of the results of an online literature review, resulted in a shortened LOS and lower hospital charges compared with controls. MR, in association with a computerized literature search guided by the librarians, was an effective means for introducing evidence-based medicine into patient care practices.
Banks
Daniel E
DE
Department of Medicine, Louisiana State University School of Medicine, Shreveport, LA 71130, USA. dbanks3@lsuhsc.edu
Shi
Runhua
R
Timm
Donna F
DF
Christopher
Kerri Ann
KA
Duggar
David Charles
DC
Comegys
Marianne
M
McLarty
Jerry
J
D019090:Case Management; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D016247:Information Storage and Retrieval; D033183:Interdisciplinary Communication; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D007902:Length of Stay; D016245:Librarians; D007992:Libraries, Hospital; D007999:Library Services; D008145:Louisiana; D011361:Professional Competence; D024382:Professional Role; D015397:Program Evaluation