2.50
Hdl Handle:
http://hdl.handle.net/10755/162690
Type:
Presentation
Title:
Using a Rapid Discharge Process During a Disaster!
Abstract:
Using a Rapid Discharge Process During a Disaster!
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Dugan, Lisa, MSN, RN, CNA-BC
P.I. Institution Name:Inova Loudoun Hospital
Title:Sr. Director, Emergency Services
Contact Address:, Leesburg, VA, 20176-, USA
Contact Telephone:(703) 858-6773
Co-Authors:Karen Gabel Speroni, PhD, RN; Marlon Daniel, BS, MPH, MHA
Purpose: To rapidly allocate treatment spaces and surge during a disaster, nurses need an efficient and systematic process to discharge hospitalized patients. A retrospective study was conducted evaluating a computerized database system [QuadraMed's Indicator Detail Report (QIDR)* patient classification system] and its ability to categorize dischargeable patients.

Design: Retrospective chart review comparing discharge data between two groups:
1) QIDR group: Patients who met QIDR discharge criteria on day of review.
2) Non-QIDR group (NQIDR): Discharged patients who did not meet discharge criteria on day of review.

Setting: Acute-care 155-bed hospital in close proximity to Washington, D.C.

Subjects: In-patients on medical, telemetry or post-surgical units, 18 years of age or older.

Methods: Retrospective chart review of 1,601 discharges between January and September 2005, was conducted via daily review using the QIDR database. Patient's discharge readiness was assessed using QIDR patient classification. Reasons for non-discharge and readmission within 7 days post-discharge were documented. IRB approval was obtained.

Results: A total of 1,156 QIDR evaluations and 445 NQIDR evaluations were reviewed following the hospital's existing discharge process comparing:
1) The QIDR patients who met criteria for discharge on the day of review and were discharged the same day versus patients who met the QIDR criteria but were not discharged.
2) The QIDR patients who met criteria for discharge on the day of review and were discharged the same day versus the NQIDR patients who were discharged on the day of review.

The total number of QIDR patients discharged on the day of review was 839, or 73%. There was a 1.8% readmission rate for the QIDR group (21 patients) versus 2.7% (12) for the NQIDR group. There was no association between readmission and meeting QIDR discharge criteria (P = 0.0509), a = 0.05.

The sensitivity of the QIDR process in correctly determining day of discharge was as follows: 47% per comparison of QIDR patients discharged on the day of review versus QIDR patients not discharged on day of review; if discharged 24 hours later, sensitivity was 72.5% and at 48 hours sensitivity was 83%.

Recommendations: Further research is warranted to facilitate a hospital's emergency management plan, to provide an objective, systematic and safe process to identify the most appropriate patients for discharge while decreasing the potential for their readmission.

*QuadraMed Corp, Reston, Virginia
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleUsing a Rapid Discharge Process During a Disaster!en_GB
dc.identifier.urihttp://hdl.handle.net/10755/162690-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Using a Rapid Discharge Process During a Disaster!</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dugan, Lisa, MSN, RN, CNA-BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Inova Loudoun Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Sr. Director, Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Leesburg, VA, 20176-, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(703) 858-6773</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lisa@lh.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Karen Gabel Speroni, PhD, RN; Marlon Daniel, BS, MPH, MHA</td></tr><tr><td colspan="2" class="item-abstract">Purpose: To rapidly allocate treatment spaces and surge during a disaster, nurses need an efficient and systematic process to discharge hospitalized patients. A retrospective study was conducted evaluating a computerized database system [QuadraMed's Indicator Detail Report (QIDR)* patient classification system] and its ability to categorize dischargeable patients. <br/><br/>Design: Retrospective chart review comparing discharge data between two groups: <br/>1) QIDR group: Patients who met QIDR discharge criteria on day of review.<br/>2) Non-QIDR group (NQIDR): Discharged patients who did not meet discharge criteria on day of review. <br/><br/>Setting: Acute-care 155-bed hospital in close proximity to Washington, D.C.<br/><br/>Subjects: In-patients on medical, telemetry or post-surgical units, 18 years of age or older. <br/><br/>Methods: Retrospective chart review of 1,601 discharges between January and September 2005, was conducted via daily review using the QIDR database. Patient's discharge readiness was assessed using QIDR patient classification. Reasons for non-discharge and readmission within 7 days post-discharge were documented. IRB approval was obtained. <br/><br/>Results: A total of 1,156 QIDR evaluations and 445 NQIDR evaluations were reviewed following the hospital's existing discharge process comparing: <br/>1) The QIDR patients who met criteria for discharge on the day of review and were discharged the same day versus patients who met the QIDR criteria but were not discharged. <br/>2) The QIDR patients who met criteria for discharge on the day of review and were discharged the same day versus the NQIDR patients who were discharged on the day of review. <br/><br/>The total number of QIDR patients discharged on the day of review was 839, or 73%. There was a 1.8% readmission rate for the QIDR group (21 patients) versus 2.7% (12) for the NQIDR group. There was no association between readmission and meeting QIDR discharge criteria (P = 0.0509), a = 0.05. <br/><br/>The sensitivity of the QIDR process in correctly determining day of discharge was as follows: 47% per comparison of QIDR patients discharged on the day of review versus QIDR patients not discharged on day of review; if discharged 24 hours later, sensitivity was 72.5% and at 48 hours sensitivity was 83%.<br/> <br/>Recommendations: Further research is warranted to facilitate a hospital's emergency management plan, to provide an objective, systematic and safe process to identify the most appropriate patients for discharge while decreasing the potential for their readmission. <br/><br/>*QuadraMed Corp, Reston, Virginia</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:30Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:30Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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