Timely care for frail older people referred to hospital improves efficiency and reduces mortality without the need for extra resources

Age and Ageing

Volumn 43, Issue 4, 2014, Pages 472-477

  Silvester, Kate M ^a,b   Mohammed, Mohammed A ^c   Harriman, Paul ^d   Girolami, Anna ^d   Downes, Tom W ^d  

^a UNIVERSITY OF WARWICK   (United Kingdom)

^b UNIVERSITY OF WARWICK   (United Kingdom)

^c UNIVERSITY OF BRADFORD   (United Kingdom)

^d SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

Efficiency; Frailty; Improvement science; Mortality; Older people; Systems thinking

Indexed keywords

AGED; ARTICLE; EMERGENCY CARE; EMERGENCY PATIENT; EMERGENCY WARD; FEMALE; FLOW MEASUREMENT; FRAIL ELDERLY; HEALTH CARE PLANNING; HEALTH CARE UTILIZATION; HOSPITAL ADMISSION; HOSPITAL BED UTILIZATION; HOSPITAL READMISSION; HUMAN; MAJOR CLINICAL STUDY; MALE; MORTALITY; NUMBERS NEEDED TO TREAT; PATIENT REFERRAL; PRIORITY JOURNAL; PROSPECTIVE STUDY; RESOURCE ALLOCATION; RISK ASSESSMENT; RISK REDUCTION; TIME SERIES ANALYSIS; EMERGENCY HEALTH SERVICE; GERIATRIC ASSESSMENT; HEALTH CARE DELIVERY; LENGTH OF STAY; LONGITUDINAL STUDY; NATIONAL HEALTH SERVICE; STANDARDS; STATISTICS AND NUMERICAL DATA; TIME TO TREATMENT; TREATMENT OUTCOME; TRENDS; UNITED KINGDOM; VERY ELDERLY;

AGED; AGED, 80 AND OVER; DELIVERY OF HEALTH CARE; EMERGENCY SERVICE, HOSPITAL; FEMALE; FRAIL ELDERLY; GERIATRIC ASSESSMENT; GREAT BRITAIN; HOSPITAL MORTALITY; HUMANS; LENGTH OF STAY; LONGITUDINAL STUDIES; MALE; PATIENT READMISSION; PROSPECTIVE STUDIES; STATE MEDICINE; TIME-TO-TREATMENT; TREATMENT OUTCOME;

EID: 84903180291     PISSN: 00020729     EISSN: 14682834     Source Type: Journal    
DOI: 10.1093/ageing/aft170     Document Type: Article

References (21)

1. The Royal College of Physicians. Hospitals on the Edge? The Time for Action. London, 2012.
2. Poteliakhoff E, Thompson J. Emergency Bed Use: What the Numbers Tell Us. London: The King's Fund, 2011 www. kingsfund.org.uk/publications/emergency_bed_use.html (10 December 2012, date last accessed).
3. Allder S, Sylvester K, Walley P. Understanding the current state of patient flow in a hospital. Clin Med 2010; 10: 441-4.
4. Hoogerduijn J, Schuurmans M, Duinstee M, de Rooij S, Grypdonck M. A systematic review of predictors and screening instruments to identify older hospitalized patients at risk for functional decline. J Clin Nurs 2007; 16: 46-57.
5. Lafont C, Gerard S, Voisin T, Pahor M, Vellas B, Members of IAGG/AMPA Task Force. Reducing "iatrogenic disability" in the hospitalized frail elderly. J Nutr Health Aging 2011; 15:645-60.
6. Goulding L, Adamson J, Watt I, Wright J. Patient safety in patients who occupy beds on clinically inappropriate wards: a qualitative interview study with NHS staff. BMJ Qual Saf 2012; 21: 218-24.
7. Langley GJ, Moen R, Nolan KM, Nolan TW, Normal CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance, 2nd edition. USA:Josey-Bass, 2009. ISBN: 978-0-470-19241-2.
8. Hutchinson A, Coster JE, Cooper KL, McIntosh A, Walters SJ, Bath PA, Perason M, Rantell K, Campbell MJ, Nicholl J, Irwin P. Assessing quality of care from hospital case notes:comparison of reliability of two methods. Qual Saf Health Care 2009. doi:10.1136/qshc.2007.023911.
9. Campbell D, Stanley J. Experimental and Quasi-Experimental Designs for Research. Boston: Houghton Mifflin, 1963.
10. Box GEP, Pierce DA. Distribution of residual autocorrelations in autoregressive-integrated moving average time series models. J Am Stat Assoc 1970; 65: 1509-1526.
11. Craig P, Dieppe P, Macintyre S, Mitchie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008; 337: a1655.
12. Prais SJ, Winsten CB. Trend estimators and serial correlation. In: Working paper 383, Cowles Commission, 1954. http:// cowles.econ.yale.edu/P/ccdp/st/s-0383.pdf (10 December 2012, date last accessed).
13. StataCorp. Stata Statistical Software: Release 12. College Station, TX: StataCorp LP, 2011.
14. R Development Core Team. R: a Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing, 2011. ISBN 3-900051-07-0, URL. http:// www.R-project.org/ (10 December 2012, date last accessed).
15. Bryer C, Burt S, Debbage S, Jenkins J. Clinical Assurance Toolkit, 1st edition. Mediplex Limited, 2008. http://www.hqip. org.uk/assets/Downloads/Audit-Research-Service-Evaluation. pdf (10 December 2012, date last accessed).
16. Noon CE, Hankins CT, Cote MJ. Understanding the impact of variation in the delivery of healthcare services. J Healthcare Manage 2003; 43: 82-98.
17. Gilligan S, Walters M. Quality improvements in hospital flow may lead to a reduction in mortality. Clin Governance 2008; 13: 26-34.
18. Wilson MJ, Siegel B, Williams M. Perfecting Patient Flow. America's Safety Net Hospitals and Emergency Department Crowding. National Association of Public Hospitals and Health Systems, 2005. www.naph.org (10 December 2012, date last accessed).
19. Dodds S. Three Wins: Service Redesign Through Flow Modelling. Chichester, UK: Kingsham Press, 2006 (ISBN 1-904235-54-9).
20. Yates J. Hospital Beds. A Problem for Diagnosis and Management. London, UK: William Heinmann Medical Books, 1982.
21. The Joint Commission. 2011 Comprehensive Accreditation Manual for Hospitals: The Official Handbook. Oak Brook, IL:Joint Commission Resources, 2010.