A multi-disciplinary approach to designing safer healthcare was utilised to investigate risks in the bed-space in elective surgical wards.
She was admitted to the gastroenterology ward for elective ESWL) followed by endoscopic retrograde sphincterotomy.
We adjusted hospital stay appropriateness for appropriateness in admission, type of admission (urgent vs elective) and type of ward (surgical vs medical): a recently published study [ 27] confirms the importance of inappropriateness in admission which accounts for 14% of acute hospitalizations.
Patients admitted to the surgical study wards for elective surgery with an expected length of stay of more than 48 hours will be included.
Two clusters of C difficile infection (CDI, C difficile clusters 1 and 2) from a medical ward and an elective surgical unit were also investigated.
To illustrate this in terms of bed utilisation, if for example we assume an average LOS for elective patients on a surgical ward is 7 days, then the 266 days lost due to avoidable non-surgical delays equates to admitting and discharging a further 38 patients during this 4 month period, or greater than 100 patients over a year.
With respect to generalizability we can ask the question whether the TRENT Index can be used in hospital ward contexts (emergency and elective) outside the simulated environment.
From January 2014 through January 2015, patients admitted to 4 wards, including: Ortho1 (sport traumatology), Ortho 2 (septic); Geriatrics (2 wards) and patients undergoing elective colorectal surgery (ECS) were screened from April 2013-October 2014.
The source of admission was categorized as: (a) emergency room (ER), patients who were admitted after ER or family doctor visit or after emergency surgery were placed in this category, (b) post operative, following elective surgery, (c) other hospital, including ER, ward and PICU of that hospital and (d) paediatric ward of own hospital.
Thereafter, patients who require additional care are transferred to regular wards that also admit elective patients.
