Crilly Julia L, Boyle Justin, Jessup Melanie, Wallis Marianne, Lind James, Green David, FitzGerald Gerry
Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia (Drs Crilly, Lind, and Green); Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia (Drs Crilly, Jessup, Wallis, Lind, and Green); Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia (Dr Boyle); Nursing Education and Research Unit, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia (Drs Jessup and Wallis); Nursing Research and Practice Development Unit, The Prince Charles Hospital & Australian Catholic University, Brisbane, Queensland, Australia (Dr Jessup); School of Nursing and Midwifery, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia (Dr Wallis); and Centre for Emergency and Disaster Medicine, School of Public Health, Queensland University of Technology, Brisbane, Queensland, Australia (Dr FitzGerald).
Qual Manag Health Care. 2015 Oct-Dec;24(4):169-76. doi: 10.1097/QMH.0000000000000070.
To evaluate the implementation of a Patient Admission Prediction Tool (PAPT) in terms of patient flow outcomes and decision-making strategies.
The PAPT was implemented in 2 Australian public teaching hospitals during October-December 2010 (hospital A) and October-December 2011 (hospital B).
A multisite prospective, comparative (before and after) design was used. Patient flow outcomes measured included access block and hospital occupancy. Daily and weekly data were collected from patient flow reports and routinely collected emergency department information by the site champion and researchers.
Daily decision-making strategies ranged from business as usual to use of overcensus beds. Weekly strategies included advanced approval to use of overcensus beds and prebooking nursing staff. These strategies resulted in improved weekend discharges to manage incoming demand for the following week. Following the introduction of the PAPT and workflow guidelines, patient access and hospital occupancy levels could be maintained despite increases in patient presentations (hospital A).
The use of a PAPT, embedded in patient flow management processes and championed by a manager, can benefit bed and staff management. Further research that incorporates wider evaluation of the use of the tool at other sites is warranted.
