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Showing 5 results for Length of Stay
Performance Evaluation In Hospitals Of Lorestan University Of Medical Sciences Using Pabon-Lasso Model  
Zahra Kavosi, Sahar Goodarzi, Abdollah Almasiankia,
Volume 6, Issue 5 (1-2013)
Abstract

Background and Aim: Assessment of hospital performance increases responsiveness and efficiency of limited resources. One of the most useful models of hospital performance assessment is Pabon-Lasso, a graphical model that determines the relative performance of hospitals using three indicators: Bed Occupancy Rate Bed Turnover and Average Length of Stay. The present study aims to compare the performance of Lorestan University of Medical Sciences (LUMS) hospitals using the above-mentioned tools.

Materials and Methods: In this descriptive cross-sectional study, fourteen LUMS hospitals were selected through census. The data-gathering instrument was the standard data form verified by the Ministry of Health and Medical Education. Bed Occupancy Rate, Average Length of Stay, and Bed Turnover Rate were calculated and Pabon-Lasso graph was drawn using SPSS 15.

Results: The average length of stay, bed occupancy, and bed turnover rates turned out to be 3/21 days, 53/07% and 95/54, respectively. Five hospitals were in Zone III, indicating a satisfactory level of efficiency. Four hospitals demonstrated inefficiency and underutilization of resources by falling into Zone I. Three hospitals were placed n Zone II. And two hospitals were in Zone IV.

Conclusion: Among 14 studied hospitals, just 5 were considered as efficient. Therefore, it is necessary that policy-makers develop solutions to improve the performance of other hospitals and distribute health resources appropriately.


Investigation of Appropriateness of Patient Hospitalization Based on Appropriateness Evaluation Protocol (AEP)
Zahra Meidani, Mehrdad Farzandipour, Hamidreza Gilasi, Manizheh Shekrachi, Zahra Nazemibidgoli,
Volume 10, Issue 4 (9-2016)
Abstract

Background and Aim: In attention to hospital beds serves as an invaluable resource in health system and necessity for appropriate hospital beds utilization through the reduction of patient inappropriate stay, this study aimed to assess the proportion and causes for hospital inappropriate stays. 
Materials and Methods: The proportion and causes for hospital inappropriate stays were analyzed in a cross-sectional survey using a sample of 1925 days of hospital stay based on the Appropriateness Evaluation Protocol. The study was conducted at the tertiary care University Hospital Shahid Beheshti, 510 – bed teaching hospital which is located in the central part of Iran.
Results: Hundred and twenty one days (6.3%) of 1925 days of patient hospitalization were inappropriate. There was relationship between inappropriate stay and patients’ age and types of insurance. Findings relating to analysis of patient non demographic causes revealed that among hospitals, physicians and patient causes, Hospital-related causes and Physicians related causes have the most impact 42 (33.1%) and 37 (29.1%) on patient inappropriate stay  respectively. 
Conclusion: AEP list of reasons provides base line data for performance improvement in health care organizations. For conducting improvement process, developing a multidisciplinary team under title of Utilization Review committee is recommended to pave the way for targeted interventions based on identified potential causes. 


A Survey of Patients' Length of Stay and Its Effective Predictors in Emergency Departments of TUMS Selected Hospitals
Hamed Basir Ghafouri, Mohammad Hosseini Kasnavieh, Marziye Alsadate Sharifi, Milad Amini, Amirreza Darzi Ramandi ,
Volume 11, Issue 3 (7-2017)
Abstract
Background and Aim: Hospitals should be able to satisfy their clients’ needs in less time and with best quality possible. Length of Stay (LOS) in hospitals is considered as a key performance indicator, especially in emergency departments. In this study, the analysis of LOS in emergency departments was performed so that some of the factors affecting patients’ length of stay could be found. 
Materials and Methods: This descriptive-analytical and cross-sectional study was performed in the emergency departments of two teaching hospitals of Tehran University of Medical Sciences (TUMS). Seventy-two patient samples were included. The patients’ length of stay in emergency ward was measured from the entrance time until the time they left the emergency department. Data on both descriptive (mean and standard deviation) and analytical statistics (one-way ANOVA, independent sample t-test and linear regression) were analyzed with SPSS software.
Results: Patients’ average LOS in emergency departments was estimated at around 3 hours and 13 minutes (SD=1.52). Such variables as patients’ marital status, days of the week (holidays or regular days) and admission time (day or night) were determined as the factors affecting LOS. 
Conclusion: The time spent to give services in hospital emergency rooms is at an appropriate level and items such as marital status, holidays of a week, and time of the day can be referred to as factors affecting patients’ length of stay. With regard to these findings, health managers can rely on the results for the effective planning and management of hospital emergency departments.

The Relationship between Experimental Use of Antibiotics and Length of Stay in Premature Infants Admitted to NICU of one of Educational Hospitals in Tehran
Fatemeh Esmaili, Najmeh Ashouri, Seyedeh Mahboobeh Hosseini Zare,
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Antibiotics are one of the most commonly used drugs that help to heal and treat diseases, but improper administration and excessive use of them can increase length of stay and cost of hospitalization. The purpose of this study was to analyze relationship between experimental use of antibiotics and duration of stay of premature infants admitted to Mahdiyeh hospital in Tehran.
Materials and Methods: This descriptive-analytical and cross-sectional study was carried out in 2019 on 159 premature infants admitted to intensive care ward of Mahdiyeh hospital in Tehran were investigated. The study tool was a questionnaire that validity of questionnaire was measured by content analysis method and reliability of questionnaire was measured by Cronbach’s alpha method. Data analysis was done using SPSS software, with help of descriptive statistics of frequency and percentage and statistical test of one-way analysis of variance and independent t-test.
Results: The results showed that 52.2% of infants were girls and 79.9% of deliveries were performed by cesarean section. The average length of stay of infants was 31.47 days and average birth of infants was 30 weeks. According to results of study, there was a significant relationship between length of hospitalization of infants with duration of antibiotic treatment and number of periods of receiving antibiotics (P<0.05). The duration of hospitalization of infants with a period of receiving less than 14 days of antibiotics was almost half of duration of hospitalization of infants with more than 14 days of receiving antibiotics. Also, there was a significant relationship between number of antibiotic courses and length of hospitalization of patients (P<0.05). With increase in number of antibiotic sessions, duration of hospitalization of infants increased significantly. The results of study showed that there was a significant relationship between birth weight of babies, cost of bed, and total cost of experimental administration of antibiotics (P<0.05).
Conclusion: Considering that rational use of antibiotics reduce length of stay of hospitalized infants, Ministry of Health should develop an updated and transparent antibiotic adminstration protocol for premature infants and awareness physicians to inform particularly prescription of antibiotics and implementation of stewardship antibiotic programs in neonatal intensive care unit. Also the publication of standard treatment guidelines, instructions including importance of prescribing antibiotics with correct dose and clinical education of physicians are necessary.
 

Presenting a Simulation Model to Optimize the Patient’s Movement Flow and Length of Stay (Study Case: In the Emergency Department of a Selected Specialized Hospital in Zahedan City)
Mohammadreza Asghariyan, Farzad Firouzi Jahantigh,
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: The emergency department of the hospital is considered one of its main entrances; which has provided health care and treatment for critical and non-critical patients and faces various health and treatment restrictions, but the main emphasis is always on resource limitations. Many simulation projects were implemented in hospitals and first in emergency departments with the aim of increasing productivity. The present research is a general description of the patient’s movement flow and length of stay in the emergency department of a selected specialized hospital in Zahedan city. The aim of the current research is to prevent care complications, reduce waiting time and patient stay in the emergency department, present a simulation model and improve it based on discrete-event simulation.
Materials and Methods: Using the data bank of the emergency department system based on the required data and also through the in-person observation of the data related to the duration of the patient’s stay in the emergency department, including the arrival time, waiting time, The type of services provided to the patient, the time of service and the time of departure were collected and checked and confirmed by experts related to this field so that it has the highest level of reliability with the facts. The data were designed in Excel software, and then data analysis and simulation model creation were done using Aren V14 software, and according to the results, the effect of the proposed solutions was evaluated.
Results: The findings of the present research showed that the longest queue created in the emergency department of the selected specialized hospital in Zahedan city is related to medical examination and additional tests. By implementing the simulation model and testing different solutions, solution 3, which means adding one nurse to nursing consultation and one person to radiology, has the most optimizing effect on the performance of the system at different levels of the patient admission process. and the cost of its implementation is more than solutions 1 and 2. This solution created a 14% decrease in the average length of stay and a 28% decrease in the average duration of additional tests.
Conclusion: The use of queuing models and simulation techniques improve the performance of the system and their implementation has significant effects on reducing the waiting time and length of stay of patients in the emergency department, increasing the quality level of the process of monitoring patients. It leads to optimal management of resources and increased productivity.
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