Abstract: Overcrowding in general medical wards, increasing patient complexity, and rising demand for subspecialty care present significant challenges to healthcare delivery in resource-limited settings. Traditional ward structures often result in delayed diagnoses, prolonged hospital stays, and inefficient resource utilization. To establish a model medical subspecialty ward to deliver focused, multidisciplinary, and efficient specialist care while reducing overcrowding in general medical wards and improving patient outcomes. A quality improvement initiative was implemented at District General Hospital Nawalapitiya beginning in 2023. The intervention involved creating a dedicated medical subspecialty ward with structured multidisciplinary teams, standardized care pathways, and fast-track admission systems. Data sources included patient feedback, ward-level discussions, and transfer records to tertiary care centres. The implementation of the subspecialty ward resulted in improved patient flow, reduced overcrowding in general medical wards, enhanced multidisciplinary collaboration, and improved staff satisfaction. The results of the project were tangible and significant. From August 2023 to August 2025, Haematology admissions increased from 321 to 403, Dermatology from 131 to 155, Pulmonology from 158 to 208, and Cardiology from 88 to 233, indicating an overall rising trend across these specialties. Average length of stay decreased to 2.3 days from 4.5 days, reflecting earlier subspecialty input and more coordinated care. Bed occupancy rate decreased from 67% to 52% after the establishment of Medical Subspecialty Ward, easing congestion in general medical wards and improving access for acute admissions. Nurses and allied health professionals reported greater role clarity and professional recognition, while doctors benefitted from embedded subspecialty learning. The hospital also reduced unnecessary referrals to tertiary centres strengthening system integration at regional level. Establishing a dedicated medical subspecialty ward significantly improves efficiency, patient-centred care, and healthcare delivery outcomes. This model demonstrates a scalable approach for optimizing hospital services and strengthening health systems. Keywords: Hospital efficiency, Medical Subspeciality Ward, Multidisciplinary care, Patient-centred care, Quality improvement, Subspecialty care. Title: Establishment of a Model Medical Subspecialty Ward to Deliver Specialist Care Productively: A Quality Improvement Initiative at District General Hospital Nawalapitiya - Sri Lanka Author: Somaratne CJK, Weraduwage K, Raqeeb A International Journal of Recent Research in Commerce Economics and Management (IJRRCEM) ISSN 2349-7807 Vol. 13, Issue 2, April 2026 - June 2026 Page No: 15-20 Paper Publications Website: www.paperpublications.org Published Date: 10-April-2026 DOI: https://doi.org/10.5281/zenodo.19498761 Paper Download Link (Source) https://www.paperpublications.org/upload/book/Establishment%20of%20a%20Model%20Medical-10042026-9.pdf
CJK et al. (Fri,) studied this question.