Churn: patient turnover and case mix.

Area of Science:

• Healthcare Management
• Nursing Operations
• Hospital Throughput Analysis

Background:

• Patient throughput and casemix changes are critical but poorly understood aspects of nursing ward management.
• Nursing unit managers require better metrics to assess and improve operational efficiency and quality standards.

Purpose of the Study:

• To analyze patient movement (churn) and casemix changes at the nursing unit level across Australian public hospitals.
• To investigate the impact of patient flow on hospital operations and nursing responsibilities.

Main Methods:

• Analysis of patient movement data across 286 wards in 27 Australian public hospitals over a 5-year period.
• Examination of casemix variations at the nursing unit level.

Main Results:

• Medical/surgical patients moved more than twice on average during hospital stays of approximately 4 days.
• Significant patient churn was observed, indicating dynamic ward environments.

Conclusions:

• The lack of ward-level metrics hinders nursing managers' ability to meet efficiency and quality targets.
• Measuring patient churn can provide valuable insights for senior management and nurse executives regarding hospital operations, staff, patient care, and resource allocation.