RESUMEN
The CONTINUUM-Activity Index was used as a concurrent tool to measure intensity of services delivered in an Acute Care Community Hospital. Applying these specific daily measures identified patients who did not meet admission-appropriateness criteria on the first day of care or did not meet those criteria on two days subsequent to admission. These patients had a high probability that their entire stay would be inappropriate. Action was then taken to move the care process forward, resulting in a significant reduction in inappropriate hospital days.
Asunto(s)
Revisión Concurrente/métodos , Mal Uso de los Servicios de Salud , Hospitales Comunitarios/estadística & datos numéricos , Pacientes Internos/clasificación , Ocupación de Camas , Presupuestos , Canadá , Continuidad de la Atención al Paciente/clasificación , Eficiencia Organizacional , Indicadores de Salud , Hospitales Comunitarios/economía , Hospitales Comunitarios/organización & administración , Tiempo de Internación , Admisión del Paciente , Proyectos PilotoRESUMEN
The authors describe the CONTINUUM project which was initiated in a community hospital to manage the appropriateness, timeliness and acceptability of the patient care process on a concurrent or day-to-day basis. CONTINUUM is a quality and data-driven approach to continuous improvement of the patient care process. The St. Thomas-Elgin General Hospital researched "appropriateness of care" measurements and adapted their use for the CONTINUUM project. A concurrent care plan evaluation tool is applied to every care every day. This intensity of service (needs-based) strategy is called the ACTIVITY index. Patients are categorized ACTIV (appropriate) or non-ACTIV (perhaps inappropriate). Non-ACTIV patients are further subdivided into various "barriers to care," from which service, hospital or physician-related factors can be stratified. Practice patterns and hospital resource use are then rapidly identified. The operational dimensions of the project (bedside, organization and community) are described as well as the inhibitors and enablers of this change process.