title: Development and validation of a tool to select patients for admission to medical short stay units.
abstract: Medical short stay units help to increase patient flow and decrease length of stay, but selecting appropriate patients for admission to such units is difficult. The selection tool used in our unit was effective but cumbersome to apply. We collected prospective data on 297 unselected emergency medical admissions and developed a new scoring system based on four key variables using regression analysis. The model predicted a length of stay of <72 h with an area under the receiver operating characteristic curve of 0.68. The model was then used to select patients for admission to the short stay unit in our trust. Length of stay on the short stay unit had decreased by an average of 2.73 days with our original selection tool, but remained unchanged at an average of 3.02 days using the new simpler tool (p > 0.05). This model could now be adopted by other units.
authors.affiliation: Department of Acute Medicine, Southmead Hospital, Bristol, UK louisepowter@nhs.net.
authors.forename: Louise
authors.initials: L
authors.lastname: Powter
authors.affiliation: Bristol Royal Infirmary, Bristol, UK.
authors.forename: Amanda
authors.initials: A
authors.lastname: Beale
authors.affiliation: Kings College London, UK.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Probert
authors.affiliation: Bristol Royal Infirmary, Bristol, UK and University of Bristol, Bristol, UK.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Dhanda
mesh_terms: D019540:Area Under Curve; D004630:Emergencies; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D015233:Models, Statistical; D010343:Patient Admission / Q000592:standards*; D018579:Patient Selection; D011446:Prospective Studies; D012044:Regression Analysis
keywords: Length of stay; acute admission; patient selection; prediction tool; short stay unit
references.citation: CMAJ. 2000 Nov 28;163(11):1477-80
references.pmid: 11192657
references.citation: Acute Med. 2007;6(3):121-3
references.pmid: 21611586
references.citation: Emerg Med Australas. 2008 Jun;20(3):216-20
references.pmid: 18062781
references.citation: Intern Emerg Med. 2011 Aug;6(4):321-7
references.pmid: 21161437
references.citation: Clin Med (Lond). 2008 Feb;8(1):18-20
references.pmid: 18335661
references.citation: J Hosp Med. 2009 May;4(5):276-84
references.pmid: 19504489
references.citation: Aust Health Rev. 2007 Nov;31(4):633-41
references.pmid: 17973623