• Saudi Med J · Nov 2023

    Impact of restructuring an inpatient pediatric service on length of stay and patient flow.

    • Tahir K Hameed, Syed F Jamil, Omar S Aldibasi, and Hamad A AlKhalaf.
    • From the Department of Pediatrics (Hameed, Jamil, AlKhalaf), King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Hameed, Jamil, AlKhalaf); from the College of Dentistry (Aldibasi), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Hameed, Jamil, Aldibasi, AlKhalaf), Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.
    • Saudi Med J. 2023 Nov 1; 44 (11): 112711311127-1131.

    ObjectivesTo determine the impact of implementing a new pediatric inpatient structure - the clinical teaching unit (CTU) - on length of stay (LOS) and other patient care outcomes.MethodsA retrospective study was carried out on children admitted to the General Pediatric Inpatient Service at King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia, between July 2015 and December 2018. The main outcome measures were median and mean LOS before and after CTU implementation. Other outcomes measured were the proportion of patients discharged on weekends, during daytime, and within 24 hours of admission, and the proportion of patients readmitted within 7 days of discharge.ResultsMedian LOS decreased from 2.80 to 2.63 days after CTU implementation (p<0.0001). The proportion of weekend discharges significantly increased after CTU implementation from 18% to 21.5% (p<0.0243) and daytime discharges significantly increased from 6.9% to 25.6% (p<0.0001) after CTU implementation. The improvements in LOS were sustained in the years after CTU implementation, with median LOS decreasing from 2.71 to 2.60 days during 2016-2018 (p<0.001) and mean LOS decreasing from 5.03 to 3.92 days (p=0.0031). During the same period, readmission rates remained stable at 3.5-4%.ConclusionThe implementation of a new pediatric inpatient team structure led to significant improvements in many patient care outcomes, including decreased LOS.Copyright: © Saudi Medical Journal.

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