Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand

© 2019 Australasian College for Emergency Medicine Objective: The present study explores factors related to length of stay (LOS) in a rural public hospital in Thailand and assesses the feasibility of using LOS as an ED key performance indicator. Methods: Using a mixed-methods approach, qualitative m...

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Main Authors: Paibul Suriyawongpaisal, Threebhorn Kamlungkuea, Natchaya Chiawchantanakit, Norramon Charoenpipatsin, Phun Sriturawanit, Pattraporn Kreesang, Thanita Thongtan
Other Authors: Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Format: Article
Published: 2020
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/51494
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spelling th-mahidol.514942020-01-27T16:37:03Z Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand Paibul Suriyawongpaisal Threebhorn Kamlungkuea Natchaya Chiawchantanakit Norramon Charoenpipatsin Phun Sriturawanit Pattraporn Kreesang Thanita Thongtan Faculty of Medicine, Ramathibodi Hospital, Mahidol University Mahidol University Medicine © 2019 Australasian College for Emergency Medicine Objective: The present study explores factors related to length of stay (LOS) in a rural public hospital in Thailand and assesses the feasibility of using LOS as an ED key performance indicator. Methods: Using a mixed-methods approach, qualitative methods (in-depth interviews, patients’ chart review and participatory observations) were used to guide and elaborate findings from quantitative analysis of 555 electronic ED records. Results: Multivariate analysis revealed that age, Emergency Severity Index score and number of laboratory tests were significantly associated with LOS. The qualitative approach provided contradicting evidence on the linkage between LOS and patient outcomes. On the one hand, considering the 4 h rule, a child with asthma was referred to a tertiary care hospital because of deterioration after 4 h of ED care. On the other hand, a woman with sepsis was hospitalised with improved condition despite 7 h of ED care. Interviews revealed the waiting time to see doctors was probably the top priority issue for patients. Conclusions: Factors related to LOS in a rural hospital in Thailand are similar and in contrast to those of a previous study in a medical school setting. Reasons for the discrepancy of findings and implications for improving ED services were discussed. Our data support the notion of controversy in using LOS as a key indicator of ED performance in this rural hospital setting. Thus, it is imperative to not rely on any single throughput or process indicators to monitor ED performance, but to take into account a set of indicators including patient outcomes. 2020-01-27T09:37:03Z 2020-01-27T09:37:03Z 2019-08-01 Article EMA - Emergency Medicine Australasia. Vol.31, No.4 (2019), 646-653 10.1111/1742-6723.13254 17426723 17426731 2-s2.0-85062356207 https://repository.li.mahidol.ac.th/handle/123456789/51494 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85062356207&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Paibul Suriyawongpaisal
Threebhorn Kamlungkuea
Natchaya Chiawchantanakit
Norramon Charoenpipatsin
Phun Sriturawanit
Pattraporn Kreesang
Thanita Thongtan
Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand
description © 2019 Australasian College for Emergency Medicine Objective: The present study explores factors related to length of stay (LOS) in a rural public hospital in Thailand and assesses the feasibility of using LOS as an ED key performance indicator. Methods: Using a mixed-methods approach, qualitative methods (in-depth interviews, patients’ chart review and participatory observations) were used to guide and elaborate findings from quantitative analysis of 555 electronic ED records. Results: Multivariate analysis revealed that age, Emergency Severity Index score and number of laboratory tests were significantly associated with LOS. The qualitative approach provided contradicting evidence on the linkage between LOS and patient outcomes. On the one hand, considering the 4 h rule, a child with asthma was referred to a tertiary care hospital because of deterioration after 4 h of ED care. On the other hand, a woman with sepsis was hospitalised with improved condition despite 7 h of ED care. Interviews revealed the waiting time to see doctors was probably the top priority issue for patients. Conclusions: Factors related to LOS in a rural hospital in Thailand are similar and in contrast to those of a previous study in a medical school setting. Reasons for the discrepancy of findings and implications for improving ED services were discussed. Our data support the notion of controversy in using LOS as a key indicator of ED performance in this rural hospital setting. Thus, it is imperative to not rely on any single throughput or process indicators to monitor ED performance, but to take into account a set of indicators including patient outcomes.
author2 Faculty of Medicine, Ramathibodi Hospital, Mahidol University
author_facet Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Paibul Suriyawongpaisal
Threebhorn Kamlungkuea
Natchaya Chiawchantanakit
Norramon Charoenpipatsin
Phun Sriturawanit
Pattraporn Kreesang
Thanita Thongtan
format Article
author Paibul Suriyawongpaisal
Threebhorn Kamlungkuea
Natchaya Chiawchantanakit
Norramon Charoenpipatsin
Phun Sriturawanit
Pattraporn Kreesang
Thanita Thongtan
author_sort Paibul Suriyawongpaisal
title Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand
title_short Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand
title_full Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand
title_fullStr Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand
title_full_unstemmed Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand
title_sort relevance of using length of stay as a key indicator to monitor emergency department performance: case study from a rural hospital in thailand
publishDate 2020
url https://repository.li.mahidol.ac.th/handle/123456789/51494
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