title: Improving patient care with shorter hospital admissions.
abstract: Prolonged hospital admissions frequently overshadow the experience of gynaecological cancer patients. In East Kent, we identified obstacles in the inpatient journey through the hospital by performing a patient pathway mapping audit of admissions in May/June 2006 and 2007. We achieved substantial reductions in the length of stay for major gynaecological oncology surgery. The number of the lead consultant's patients with a total duration of admission of no more than 5 days increased from one of 28 in Q1 2006 (3.6%), to 17 of 28 (60.7%) in Q4 2007. Identified problems prolonging the length of stay included admission the day before surgery, prolonged use of i.v. antibiotics and late referrals to social services. Early discharge planning involving staff and patients as active participants has the greatest impact on reduction of duration of hospital admission. A reduction in duration of hospital admissions is associated with an increase in the rate of readmissions.
authors.affiliation: East Kent Gynaecological Oncology Centre, Queen Elizabeth the Queen Mother Hospital, Margate CT9 4AN, UK. katharina.schmid@doctors.org.uk
authors.forename: K J
authors.initials: KJ
authors.lastname: Schmid
authors.forename: R
authors.initials: R
authors.lastname: Tewari
authors.forename: A J
authors.initials: AJ
authors.lastname: Nordin
mesh_terms: D054869:Clinical Audit; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies