Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis

Background Healthcare systems face unprecedented numbers of patients waiting for elective treatments in the wake of the COVID-19 pandemic. Hospitals must urgently optimise patient pathways and build capacity to meet the populations health needs. Criteria-led discharge (CLD) is frequently used to opt...

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Main Authors: Huw Jones, Callum Findlay, Wei Chern Gavin Fong, Simon Goldie
Format: Article
Language:English
Published: BMJ Publishing Group 2023-02-01
Series:BMJ Open Quality
Online Access:https://bmjopenquality.bmj.com/content/12/1/e002123.full
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author Huw Jones
Callum Findlay
Wei Chern Gavin Fong
Simon Goldie
author_facet Huw Jones
Callum Findlay
Wei Chern Gavin Fong
Simon Goldie
author_sort Huw Jones
collection DOAJ
description Background Healthcare systems face unprecedented numbers of patients waiting for elective treatments in the wake of the COVID-19 pandemic. Hospitals must urgently optimise patient pathways and build capacity to meet the populations health needs. Criteria-led discharge (CLD) is frequently used to optimise elective care pathways but may hold potential in discharging patients at the end of an acute hospital admission.Methods We conducted a quality improvement project to design and introduce a novel inpatient pathway using CLD for patients with severe acute tonsillitis. Our analysis compared the standardisation of treatment, length of stay, discharge time and readmission rate between those treated on the novel pathway compared with standard treatment.Results The study population included 137 patients admitted to a tertiary centre with acute tonsillitis. Introduction of the tonsillitis pathway using CLD resulted in a significant reduction in median length of stay from 24 hours to 18 hours. Of those treated on the tonsillitis pathway, 52.2% were discharged prior to midday compared with 29.1% who received standard treatment. No patient discharged using CLD required readmission.Conclusion CLD is safe and effective at reducing length of stay in patients requiring acute hospital admission for acute tonsillitis. CLD should be used and evaluated in further novel patient pathways across different areas of medicine to optimise care and build capacity for provision of elective healthcare services. Further research is required to investigate safe and optimal criteria which indicate patients are fit for discharge.
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spelling doaj-art-f25fc52b4dec4bd39d39d2c89aeadea92024-12-31T16:10:09ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-02-0112110.1136/bmjoq-2022-002123Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitisHuw Jones0Callum Findlay1Wei Chern Gavin Fong2Simon Goldie3Department of Otolaryngology, University Hospital Southampton NHS Foundation Trust, Southampton, UKSurgery and Clinical Informatics, University Hospital Southampton NHS Foundation Trust, Southampton, Hants, UKDepartment of Otolaryngology, University Hospital Southampton NHS Foundation Trust, Southampton, UKDepartment of Otolaryngology, University Hospital Southampton NHS Foundation Trust, Southampton, UKBackground Healthcare systems face unprecedented numbers of patients waiting for elective treatments in the wake of the COVID-19 pandemic. Hospitals must urgently optimise patient pathways and build capacity to meet the populations health needs. Criteria-led discharge (CLD) is frequently used to optimise elective care pathways but may hold potential in discharging patients at the end of an acute hospital admission.Methods We conducted a quality improvement project to design and introduce a novel inpatient pathway using CLD for patients with severe acute tonsillitis. Our analysis compared the standardisation of treatment, length of stay, discharge time and readmission rate between those treated on the novel pathway compared with standard treatment.Results The study population included 137 patients admitted to a tertiary centre with acute tonsillitis. Introduction of the tonsillitis pathway using CLD resulted in a significant reduction in median length of stay from 24 hours to 18 hours. Of those treated on the tonsillitis pathway, 52.2% were discharged prior to midday compared with 29.1% who received standard treatment. No patient discharged using CLD required readmission.Conclusion CLD is safe and effective at reducing length of stay in patients requiring acute hospital admission for acute tonsillitis. CLD should be used and evaluated in further novel patient pathways across different areas of medicine to optimise care and build capacity for provision of elective healthcare services. Further research is required to investigate safe and optimal criteria which indicate patients are fit for discharge.https://bmjopenquality.bmj.com/content/12/1/e002123.full
spellingShingle Huw Jones
Callum Findlay
Wei Chern Gavin Fong
Simon Goldie
Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis
BMJ Open Quality
title Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis
title_full Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis
title_fullStr Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis
title_full_unstemmed Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis
title_short Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis
title_sort implementing criteria led discharge for acute admissions to facilitate the elective recovery from covid 19 an example in acute tonsillitis
url https://bmjopenquality.bmj.com/content/12/1/e002123.full
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