The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story

Angela Caswell; Hamad Al Khalaf; Abdullah Al Mutrafy; Rahayu Abd Rashid

doi:doi:10.11648/j.ajns.20190806.11

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The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story

Angela Caswell, Hamad Al Khalaf, Abdullah Al Mutrafy, Rahayu Abd Rashid

Published in American Journal of Nursing Science (Volume 8, Issue 6)

Received: 9 August 2019 Accepted: 24 August 2019 Published: 10 October 2019

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Abstract

Challenges to patient flow within acute hospital settings has been acknowledged internationally as a growing concern that has the potential to impact upon patient safety, satisfaction and organizational budgetary constraints. The development and introduction of a unique Pediatric Acute Unit pilot program has shown promising results which support its continued implementation. Dynamic in its approach, it has achieved a streamlined flow process, reduced overall length of stay, saved bed days (557.81) and reduced cost (1,158,377 SAR over 4 month pilot phase capturing the seasonal surge period of winter months). Using a mixed method of Plan Do Study Act (PDSA), including quantitative data collection, the team mapped the pilot study through 10 defined cycles of testing, evaluation and refinement. The (PAU) must be examined as a concept set against an overarching patient flow methodology which is part of a whole systems approach underpinning quality of care during the patient’s journey.

Published in	American Journal of Nursing Science (Volume 8, Issue 6)
DOI	10.11648/j.ajns.20190806.11
Page(s)	288-293
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Acute Unit, Short Stay, Admission Rate, Pediatric Acute Unit

References

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[3]	Marks, M. K. Lovejoy, F. H. Rutherford, P. A. Impact of a short stay unit on asthma patients admitted to a tertiary pediatric hospital. Quality Management in Healthcare. 1997; 6 (1): p 14-22.
[4]	Crocetti, M. T. Barone, M. A. Amin, D. D. Pediatric observation status beds on an inpatient unit: an integrated care model. Pediatric Emergency Care. 2004: 20 (1) p 17-21.
[5]	Mallory, M. D. Kadish, H. Zebrack, M. Nelson, D. Use of a pediatric observation unit for children with dehydration caused by gastroenteritis. Pediatric Emergency Care.
[6]	Macy, M. L. Kim, C. S. Sasson, C. Lozon, M. M. Davis, M. M. Pediatric observation units in the United States: a systematic review. Journal of Hospital Medicine 2010; 5 (3) p 172-182 2010.
[7]	Zebrack, M. Kadish, H. Nelson, D. The pediatric hybrid observation unit: an analysis of 6477 consecutive patient encounters. Pediatrics 2005; 115 (5).
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[9]	Greenberg, R. A. Dudley, N. C. Rittichier, K. K. A reduction in hospitalization, length of stay and hospital charges for croup with the institution of a pediatric observation unit. American Journal of Emergency Medicine 2006; 24 (7): p 818-821.
[10]	Miescieri, M. Nelson, D. Firth, H. Kadish, H. Children with asthma Admitted to a Pediatric Observation Unit. Pediatric Emergency care October 2005. Volume 21 Issue 10 p645-649.
[11]	Rentz, A. Kadish, H. Nelson, D. Physician satisfaction With a Pediatric Observation Unit Administered by Pediatric Emergency Medicine Physicians. Pediatric Emergency Medicine July 2004. Volume 20. Issue 7. P 430-432.
[12]	Noval, J. Campoamor, M. T. Avantas, E. Short stay medical units: an appropriate place to manage community acquired pneumonia? Annals of Medicine International 2006; 23: p 416-19.
[13]	Broquetas, J. M. Pendrent, R. Martinez-Lorens, J. M. Short stay respiratory unit: a new option for inpatient care. Archivos de Bronconemolgia (3) 2008 p 252-56.
[14]	Guirao-Martinez, R. Sempere- Selva, M. T. Lopez, A. Short –stay medical unit, an alternative to conventional hospitalization. Revista Clinica Espanola 2008; 208 (5) p 216-21.
[15]	Conners, G. P. Melzer, S. M. Committee on Pediatric Emergency Medicine 2012. Pediatric Observation Units. Pediatrics 130 (1): p 172-179.
[16]	Bardach, N. S. Vittinghoff, E. Penalaza, R. A. Edwards, J. D. Yazdany, J. Lee, H. C. Boscardin, W. J. Cabana, M. D. Dudley, R. A. Measuring Hospital Quality Using Pediatric Readmission and Revisit R36ates. Pediatrics 2013 132 (3) p 429-4.

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APA Style

Angela Caswell, Hamad Al Khalaf, Abdullah Al Mutrafy, Rahayu Abd Rashid. (2019). The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story. American Journal of Nursing Science, 8(6), 288-293. https://doi.org/10.11648/j.ajns.20190806.11

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ACS Style

Angela Caswell; Hamad Al Khalaf; Abdullah Al Mutrafy; Rahayu Abd Rashid. The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story. Am. J. Nurs. Sci. 2019, 8(6), 288-293. doi: 10.11648/j.ajns.20190806.11

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AMA Style

Angela Caswell, Hamad Al Khalaf, Abdullah Al Mutrafy, Rahayu Abd Rashid. The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story. Am J Nurs Sci. 2019;8(6):288-293. doi: 10.11648/j.ajns.20190806.11

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@article{10.11648/j.ajns.20190806.11,
  author = {Angela Caswell and Hamad Al Khalaf and Abdullah Al Mutrafy and Rahayu Abd Rashid},
  title = {The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story},
  journal = {American Journal of Nursing Science},
  volume = {8},
  number = {6},
  pages = {288-293},
  doi = {10.11648/j.ajns.20190806.11},
  url = {https://doi.org/10.11648/j.ajns.20190806.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20190806.11},
  abstract = {Challenges to patient flow within acute hospital settings has been acknowledged internationally as a growing concern that has the potential to impact upon patient safety, satisfaction and organizational budgetary constraints. The development and introduction of a unique Pediatric Acute Unit pilot program has shown promising results which support its continued implementation. Dynamic in its approach, it has achieved a streamlined flow process, reduced overall length of stay, saved bed days (557.81) and reduced cost (1,158,377 SAR over 4 month pilot phase capturing the seasonal surge period of winter months). Using a mixed method of Plan Do Study Act (PDSA), including quantitative data collection, the team mapped the pilot study through 10 defined cycles of testing, evaluation and refinement. The (PAU) must be examined as a concept set against an overarching patient flow methodology which is part of a whole systems approach underpinning quality of care during the patient’s journey.},
 year = {2019}
}

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TY  - JOUR
T1  - The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story
AU  - Angela Caswell
AU  - Hamad Al Khalaf
AU  - Abdullah Al Mutrafy
AU  - Rahayu Abd Rashid
Y1  - 2019/10/10
PY  - 2019
N1  - https://doi.org/10.11648/j.ajns.20190806.11
DO  - 10.11648/j.ajns.20190806.11
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 288
EP  - 293
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20190806.11
AB  - Challenges to patient flow within acute hospital settings has been acknowledged internationally as a growing concern that has the potential to impact upon patient safety, satisfaction and organizational budgetary constraints. The development and introduction of a unique Pediatric Acute Unit pilot program has shown promising results which support its continued implementation. Dynamic in its approach, it has achieved a streamlined flow process, reduced overall length of stay, saved bed days (557.81) and reduced cost (1,158,377 SAR over 4 month pilot phase capturing the seasonal surge period of winter months). Using a mixed method of Plan Do Study Act (PDSA), including quantitative data collection, the team mapped the pilot study through 10 defined cycles of testing, evaluation and refinement. The (PAU) must be examined as a concept set against an overarching patient flow methodology which is part of a whole systems approach underpinning quality of care during the patient’s journey.
VL  - 8
IS  - 6
ER  -

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Author Information

Angela Caswell

Department of Nursing King Abdullah Specialized Children’s Hospital, Riyadh, University of South Wales, South Bank University, London, United Kingdom
Hamad Al Khalaf

Department of Pediatrics and Bed Management King Abdullah Specialized Children’s Hospital, Riyadh University of Ottawa, Ottawa, Canada
Abdullah Al Mutrafy

Department of Medical Services, King Abdullah Specialized Children’s Hospital, Riyadh King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Rahayu Abd Rashid

Department of Pediatric Emergency, King Abdullah Specialized Children’s Hospital, Riyadh University of Huddersfield, Huddersfield, United Kingdom

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Plain Text BibTeX RIS

APA Style

Angela Caswell, Hamad Al Khalaf, Abdullah Al Mutrafy, Rahayu Abd Rashid. (2019). The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story. American Journal of Nursing Science, 8(6), 288-293. https://doi.org/10.11648/j.ajns.20190806.11

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ACS Style

Angela Caswell; Hamad Al Khalaf; Abdullah Al Mutrafy; Rahayu Abd Rashid. The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story. Am. J. Nurs. Sci. 2019, 8(6), 288-293. doi: 10.11648/j.ajns.20190806.11

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AMA Style

Angela Caswell, Hamad Al Khalaf, Abdullah Al Mutrafy, Rahayu Abd Rashid. The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story. Am J Nurs Sci. 2019;8(6):288-293. doi: 10.11648/j.ajns.20190806.11

Copy | Download

@article{10.11648/j.ajns.20190806.11,
  author = {Angela Caswell and Hamad Al Khalaf and Abdullah Al Mutrafy and Rahayu Abd Rashid},
  title = {The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story},
  journal = {American Journal of Nursing Science},
  volume = {8},
  number = {6},
  pages = {288-293},
  doi = {10.11648/j.ajns.20190806.11},
  url = {https://doi.org/10.11648/j.ajns.20190806.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20190806.11},
  abstract = {Challenges to patient flow within acute hospital settings has been acknowledged internationally as a growing concern that has the potential to impact upon patient safety, satisfaction and organizational budgetary constraints. The development and introduction of a unique Pediatric Acute Unit pilot program has shown promising results which support its continued implementation. Dynamic in its approach, it has achieved a streamlined flow process, reduced overall length of stay, saved bed days (557.81) and reduced cost (1,158,377 SAR over 4 month pilot phase capturing the seasonal surge period of winter months). Using a mixed method of Plan Do Study Act (PDSA), including quantitative data collection, the team mapped the pilot study through 10 defined cycles of testing, evaluation and refinement. The (PAU) must be examined as a concept set against an overarching patient flow methodology which is part of a whole systems approach underpinning quality of care during the patient’s journey.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - The Impact of a Pediatric Acute Unit in Reducing Length of Stay: A Success Story
AU  - Angela Caswell
AU  - Hamad Al Khalaf
AU  - Abdullah Al Mutrafy
AU  - Rahayu Abd Rashid
Y1  - 2019/10/10
PY  - 2019
N1  - https://doi.org/10.11648/j.ajns.20190806.11
DO  - 10.11648/j.ajns.20190806.11
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 288
EP  - 293
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20190806.11
AB  - Challenges to patient flow within acute hospital settings has been acknowledged internationally as a growing concern that has the potential to impact upon patient safety, satisfaction and organizational budgetary constraints. The development and introduction of a unique Pediatric Acute Unit pilot program has shown promising results which support its continued implementation. Dynamic in its approach, it has achieved a streamlined flow process, reduced overall length of stay, saved bed days (557.81) and reduced cost (1,158,377 SAR over 4 month pilot phase capturing the seasonal surge period of winter months). Using a mixed method of Plan Do Study Act (PDSA), including quantitative data collection, the team mapped the pilot study through 10 defined cycles of testing, evaluation and refinement. The (PAU) must be examined as a concept set against an overarching patient flow methodology which is part of a whole systems approach underpinning quality of care during the patient’s journey.
VL  - 8
IS  - 6
ER  -

Copy | Download