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Short stay facilities: the future of efficient paediatric emergency services
1Children's Emergency Department, Westmead Hospital, Sydney, Australia.
Insights
Short stay facilities efficiently manage pediatric patients, reducing hospital stays and saving costs. This approach is particularly effective for young children, improving emergency service efficiency.
Area of Science:
- Pediatric Emergency Medicine
- Hospital Administration
- Health Economics
Background:
- Many children admitted to hospitals require short stays (≤24 hours).
- Short stay facilities offer rapid stabilization and early discharge, leading to significant financial savings.
- Westmead Hospital's Children's Emergency Annex (CEA) serves a large pediatric population and surrounding hospitals with limited bed capacity.
Purpose of the Study:
- To evaluate the efficiency and cost-effectiveness of a short stay facility for pediatric patients.
- To assess the impact of the Children's Emergency Annex (CEA) on hospital resource utilization and patient outcomes.
- To determine the suitability of short stay facilities for specific pediatric age groups.
Main Methods:
- A 12-month prospective study (April 1994-April 1995) involving 1300 children admitted to the CEA.
- Data collection on general and hospital-specific information, including length of stay and disposition.
- Critical incident monitoring and follow-up review within 24-72 hours for all patients.
Main Results:
- The CEA significantly increased hospital efficiency by reducing bed days, saving over $500,000.
- Average length of stay was 17.5 hours; 58% of patients were 2 years old and under.
- Only 3% of children stayed beyond 24 hours, and 4% required inpatient admission.
Conclusions:
- Short stay facilities are efficient and cost-effective for rapidly stabilizing children with acute illnesses.
- Children 12 months and under are particularly well-suited for short stay care.
- Implementing short stay facilities can enhance the efficiency of pediatric emergency services with high turnover and limited bed capacity.
Abstract:
Many children admitted to hospital can stay for 24 hours or less. Short stay facilities offer such children rapid stabilisation and early discharge with considerable financial saving. A 12 month study was completed in which data were collected from the children's emergency annex (CEA) at Westmead Hospital in Sydney's western suburbs. This university based teaching hospital provides care for a large paediatric population as well as three other district hospitals with limited children's bed capacity. From April 1994 to April 1995, 1300 children were admitted and entered into a database of general and hospital-specific information. Critical incident monitoring was undertaken and follow up with review within 24-72 hours for all children. The CEA increased hospital efficiency significantly by reducing bed days, with a saving of over $500,000 to the department. The average length of stay was 17.5 hours, and 58% of users were children of 2 years and under. Only 3% remained beyond 24 hours, and another 4% were admitted to inpatient beds for continued management of the primarily diagnosed condition. No critical incident was reported during this 12 month period. Short stay facilities are efficient and cost-effective for children with acute illness who can be rapidly stabilised with early discharge without critical incident. Children 12 months and under are particularly suited to this type of facility. Short stay facilities should be used to augment efficiency within children's emergency services which have high turnover and limited bed capacity.