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Preadmission processes may improve length of stay for colorectal surgery
John Monagle1, Bruce Waxman, Steven Abourizk
1Anaesthetic Department, Dandenong Hospital, Victoria, Australia. j.monangle@southernhealth.org.au
Insights
The preadmission process (PAP) significantly reduces both preoperative and postoperative length of stay for major colorectal surgery patients. This surgical pathway optimization improves patient flow and resource utilization.
Area of Science:
- Surgical Patient Management
- Healthcare Operations Research
Background:
- Preadmission processes (PAP) are recognized for reducing preoperative hospital stays.
- Limited data exist on the impact of PAP on postoperative length of stay (LOS).
Purpose of the Study:
- To evaluate the effect of a PAP on both preoperative and postoperative LOS.
- To test the hypothesis that PAP reduces overall patient LOS.
Main Methods:
- Retrospective audit of admission and discharge times for major colorectal surgery patients.
- Analysis of 102 elective patients over a 12-month period at Dandenong Hospital.
Main Results:
- Patients admitted via PAP had an average LOS of 10.7 days versus 18.4 days for direct admissions.
- PAP reduced preoperative LOS by 4 days and postoperative LOS by 4 days.
- Benefits observed at both admission and discharge stages.
Conclusions:
- Preadmission processes effectively reduce preoperative LOS.
- PAP utilization appears to decrease postoperative LOS and potentially reduce complications.
- Further research is needed to fully elucidate PAP benefits.
Background:
The preadmission process (PAP) is known to reduce length of stay prior to surgery, but there are few data on its effects on postoperative stay. The aim of the present study was to test the hypothesis that a PAP may reduce postoperative length of stay as well as the preoperative length of stay.
Methods:
An audit of admission and discharge times for patients having major colorectal surgery was undertaken to determine the impact of the preadmission process at Dandenong Hospital. One hundred and two elective patients were identified over a 12-month period.
Results:
The 71 patients admitted through the preadmission process had a 10.7-day average length of stay compared to 18.4 days if the patients were admitted directly by the surgeon. The reduction in length of stay was contributed to by 4 days less preoperatively and 4 days less postoperatively. Thus the benefits from a preadmission service can be realized both at admission and discharge. The nature of this impact of preadmission requires further investigation.
Conclusions:
The PAP will reduce preoperative length of stay. Utilization of a PAP also appears to reduce postoperative length of stay and may reduce postoperative complications. Further investigation is required to determine the exact nature and extent of these PAP benefits.