Optimising in-patient stays for surgical patients-an analysis utilising the Red and Green Bed Days management system

Red and Green Bed Days is a hospital management system designed to identify delays during in-patient stays. This study quantified days when no activity occurred to progress a patient towards discharge.

Starting June 2018, 100 consecutive in-patient stays were recorded within the vascular department at Waikato Hospital, New Zealand. A 'green day' occurred when the planned care for that day was achieved. A 'red day' occurred when a patient only received care that did not require an acute bed. The causes of red days were identified.

There were 703 total in-patient days, with 37% red days. Patients aged between 60-79 years accounted for 57% of red days. Patients with peripheral arterial disease experienced 77.3% of the red days (severe chronic limb ischaemia 58.1% and acute limb ischaemia 19.2%). Awaiting wound dressing change, acute theatre (vascular and emergency theatre) and interventional procedure accounted for 31.9%, 11.2% and 9.2% of red days respectively. Delays to vascular ultrasound and rehabilitation review each resulted in 8.4% of red days.

This study highlights significant delays during vascular surgery admissions and provides a focus to improve patient quality of life and hospital efficiency.