title: Long-term acute care hospitals: one hospital's experience.
abstract: This article proposes that long-term acute care hospitals (LTACHs) may provide an appropriate and comparable level of care and services for the stabilized, critically ill patient. The experience of one medical center that proposes an alternative for an acute care hospital's ICU stay is described. The change in management that must occur to allow LTACH level of care to be acknowledged and accepted is presented. The outcome measurements that were used to evaluate the success and achievements are given. Outcome measurements for the patient include improved health status, quality of care, and return to prior level of functioning. Outcomes for the acute care hospital include increased utilization of LTACHs, decreased length of stay in the ICU, and improved capacity, resulting in cost-effective care. Implications are given for organizations to consider in utilizing LTACHs for care of stable, yet seriously ill, elderly ICU patients.
authors.affiliation: Department of Nursing, Pennsylvania State Milton S. Hershey Medical Center, 500 University Dr, Hershey, Pennsylvania 17033, USA. dhimes@hmc.psu.edu
authors.forename: Deborah
authors.initials: D
authors.lastname: Himes
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D000208:Acute Disease / Q000628:therapy*; D000368:Aged; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003362:Cost-Benefit Analysis; D016638:Critical Illness / Q000628:therapy*; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008134:Long-Term Care / Q000458:organization & administration*; D017146:Models, Organizational; D015279:Organizational Culture; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration; D010414:Pennsylvania; D011367:Professional Staff Committees / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D011383:Progressive Patient Care / Q000458:organization & administration; D011787:Quality of Health Care; D020127:Recovery of Function