Effect on a geriatric service of opening a 25-bed ward on the district general hospital site: an audit

Notes and discharge summaries of 2,560 patients were analysed in a pre-planned study to determine how the establishment of a 25-bed assessment ward on the district general hospital (DGH) site affected the work of a geriatric unit that had previously had no DGH beds. Throughput, changes in referrals and practice, and changes in outcome were measured using a computerised programme which examined the work of the unit for a year before and a year after the opening of the assessment ward. There were no changes in overall bed numbers or staffing, so changes were likely to be the direct result of establishing the DGH beds. The second year of the study showed a 33% increased throughput, with increased referrals from the accident and emergency department and evidence of more active investigation and treatment and a tendency towards a shorter length of stay. There was an increased number of transfers from all departments to the geriatric department for rehabilitation and a shortened time interval to transfer. Admissions to the general medical unit for patients aged 65-74 and 75+ did not change.