Implementing Appropriate Length of Stay Using a Collaborative Model: One Institution's Experience

Paper

Friday, 21 July 2006

This presentation is part of : Using Evidence to Determine Health Strategies

Melanie Basso, RN, BSN, MSN, PNC(C), Maternal Fetal Newborn, BC Womens' Hospital and Health Centre, Vancouver, BC, Canada and Yvonne Law, BSc, High risk Antepartum/Postpartum, BC Women's Hospital and Health Centre, Vancouver, BC, Canada.

Learning Objective #1: understand the Institute for Health Care Improvement (IHI) Collaborative Improvement Model and how it was implemented at BC Women's Hospital.
Learning Objective #2: understand the improvements to patient flow and to length of stay for women who had uncomplicated vaginal and cesarean births at BC Women's Hospital.

BC Women’s Hospital and Health Centre in Vancouver, B.C. has undertaken the Appropriate Length of Stay (LOS) Collaborative to address the question, “How will we safely achieve optimal lengths of stay for the uncomplicated vaginal and caesarean deliveries at BCW’s Hospital?” The primary focus of this initiative is to make system-wide improvements to maintain and/or improve patient safety, quality of care and patient/staff satisfaction while reducing the overall postpartum length of stay for uncomplicated vaginal and caesarean deliveries. The goal of the Collaborative, underway since October 2004, is to integrate research based practice, care delivery and system design changes that will have a positive impact on patient care. Using the Institute for Healthcare Improvement’s model of PDSA (Plan, Do, Study, Act), participants gain insights into their own care system and how it can work better. Initiatives are aimed at smoothing patient flow, creating more time for quality care and removing institutional barriers which keep women in hospital, such as newborn screening practices. Discharge criteria, based on Provincial and National Guidelines and best practices were developed using multidisciplinary team participation. Pre-data on length of stay for spontaneous vaginal deliveries (SVD), planned and emergency caesarean section (C/S) patients are compared with data collected post-Collaborative. Other indicators to be measured include readmission rates, infection rates and delays in inductions. This process for implementing system wide change is a joint effort among multiple individuals and/or organizations to achieve goals that would not have been attainable for an individual or organization working on its own.

See more of Using Evidence to Determine Health Strategies
See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)