Delays in discharge of vascular surgical patients: a prospective audit.
OBJECTIVE
To quantify delays in discharge for vascular surgical patients and identify causes of such delays.


METHODS
A prospective audit of delays in discharge of vascular surgical admissions over a 6-month period was performed. Expected date and time of discharge was compared with actual date and time of discharge. Day-case patients, patients who died during admission and patients not under the direct care of the vascular team were excluded.


RESULTS
There were 99 elective and 51 acute admissions accounting for 729 hospital bed days. The median (range) age was 72 years (21-92) and 94% of patients were living independently in the community. Forty-seven percent of patients were discharged on the planned day and time, 21% on the planned day but at a later-than-predicted time and 32% were delayed by more than 1 day. Delays identified in this audit accounted for 135 bed days. Fifteen percent of delays were due to causes that can be improved by internal organization (e.g. delayed paperwork). The majority of the delays (85%) were due to external factors such as lack of rehabilitation beds or lack of placement facilities in nursing homes. Elderly patients and acute admissions were more likely to have long delays in discharge.


CONCLUSIONS
Delays in discharge of vascular surgical patients use a lot of acute surgical bed days. Strategies to prevent delays in discharge should include not only improving internal organization and early identification and referral of patients who require rehabilitation/placement but also increased funding for such essential non-acute services.
Edirimanne
Senarath
S
Department of Vascular, Endovascular and Transplant Surgery, Christchurch Hospital, Christchurch, New Zealand.
Roake
Justin A
JA
Lewis
David R
DR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013997:Time Factors; D014652:Vascular Diseases / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data*; D055815:Young Adult