Management of alternate level of care patients using a computerized database

Area of Science:

• Healthcare Management
• Health Informatics
• Hospital Administration

Background:

• Alternate Level of Care (ALC) describes hospitalized patients ready for discharge but awaiting post-hospital care arrangements.
• ALC status presents significant challenges for patients, families, and healthcare facilities, impacting resource allocation and patient flow.
• Effective management of ALC patients is crucial for optimizing hospital operations and patient outcomes.

Purpose of the Study:

• To describe an urban teaching hospital's experience managing patients with Alternate Level of Care status.
• To detail the development and implementation of a computerized database for tracking and managing the ALC population.
• To identify key factors contributing to prolonged ALC stays.

Main Methods:

• Development of a computerized database to systematically collect data on ALC patients.
• Analysis of patient demographics and discharge barriers, including age, nursing home placement, family issues, and Medicaid eligibility.
• Implementation of a revised workflow for Medicaid application processing.

Main Results:

• Key factors contributing to extended ALC stays included patient age, delays in nursing home placement, family-related discharge obstacles, and pending Medicaid eligibility.
• The computerized database provided actionable insights into the drivers of ALC.
• Transferring Medicaid application preparation to Social Work Services streamlined the process.

Conclusions:

• Data-driven insights from a computerized ALC database can identify critical discharge barriers.
• Targeted interventions, such as optimizing Medicaid application processes, can effectively reduce ALC length of stay.
• Improved management of ALC patients enhances hospital efficiency and patient care continuity.