Standardizing admission and discharge processes to improve patient flow: a cross sectional study

Background: The aim of this study was to evaluate how hospital capacity was managed focusing on standardizing the admission and discharge processes. Methods: This study was set in a 900-bed university affiliated hospital of the National Health Service, near Barcelona (Spain). This is a cross-sectional study of a set of interventions which were gradually implemented between April and December 2008. Mainly, they were focused on standardizing the admission and discharge processes to improve patient flow. Primary administrative data was obtained from the 2007 and 2009 Hospital Database. Main outcome measures were median length of stay, percentage of planned discharges, number of surgery cancellations and median number of delayed emergency admissions at 8:00 am. For statistical bivariate analysis, we used a Chi-squared for linear trend for qualitative variables and a Wilcoxon signed ranks test and a Mann-Whitney test for non-normal continuous variables. Results: The median patients' global length of stay was 8.56 days in 2007 and 7.93 days in 2009 (p < 0.051). The percentage of patients admitted the same day as surgery increased from 64.87% in 2007 to 86.01% in 2009 (p < 0.05). The number of cancelled interventions due to lack of beds was 216 patients in 2007 and 42 patients in 2009. The median number of planned discharges went from 43.05% in 2007 to 86.01% in 2009 (p < 0.01). The median number of emergency patients waiting for an in-hospital bed at 8:00 am was 5 patients in 2007 and 3 patients in 2009 (p < 0.01). Conclusions: In conclusion, standardization of admission and discharge processes are largely in our control. There is a significant opportunity to create important benefits for increasing bed capacity and hospital throughput

Determination of potential allergenic fungal flora and its clinical reflection in suburban elementary schools in Izmir

WOS: 000280640500058PubMed ID: 19731058In this research, in order to determine mean fungus counts, indoor and outdoor air samples were taken in five elementary school buildings located in the city center of Seferihisar, Izmir (45 km from Izmir) within a 1-year period between March and April 2004, and between January and February 2005 representing similar climatic characteristics. Five samples, three from three classes where 5-8, 10-12, and 12-15 age group students attended, one from the corridors, and one from outside the buildings in all the schools, were taken for each period. Within the period of the study, in indoor and outdoor air samples, 7,122 microfungus colonies were counted. Sixty-four species were identified that belong to 17 genera as a result of the identification of isolates obtained. Skin prick tests were applied to 55 out of a total of 117 teachers by the clinicians. According to these test results, 24 teachers were sensitive to at least one agent. Results revealed that, in terms of mold counts, the difference between the schools and the difference between the times (periods) were statistically significant (p < 0.05)