Design:  An exploratory multi-hospital study designed to measure the effects of clinical unit placement on length of stay and care costs while accounting for individual care needs.  Focus was placed on the effects of intra-hospital transfers.  Intra-hospital transfers were defined as either patient driven or system driven based upon an assessment of patient care needs both pre and post transfer.  Care needs were measured using a transportable patient classification system.  Outcome measures included patient length of stay and care costs.

Population, Sample, Setting and Year:  Six United States acute-care organizations’ comprehensive databases were analyzed using a three-month, 2005 sample.

Variables:  Independent variables included patient clinical unit placement and number of intra-hospital transfers; dependent variables included patient length of stay and care costs; and control variables included patient age, DRG, daily acuity and daily complexity measures.

Methods:  Patient placement and intra-hospital transfers were classified as patient driven or system driven by comparing patient needs to the unit clinical specialization and staffing.  Patient outcomes were contrasted based upon the defined patient placement and transfer categories.

Findings:  Relationships between clinical unit placement accounting for individual care needs and the outcome measures were quantified.

Conclusions:  A model explaining the relationship between clinical unit placement and specified outcomes while accounting for individual care needs was established which identified possible opportunities for care process improvement.

See more of Measuring Evidence-Based Practice Outcomes
See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)