Key result
A surgical CDU is linked to ~67% more 24-hour discharges and shorter hospital stays.
Why the study?
The impact of a surgical clinical decisions unit on outcomes and efficiency for unscheduled general surgery admissions had not been widely implemented or studied.
Does a surgical clinical decisions unit improve discharge rates and reduce hospital stay for unscheduled general surgery admissions?
Population
All unscheduled general surgical admissions to a hospital over three years
Comparison
Admissions before vs after introduction of a surgical clinical decisions unit
Design
Prospective cohort study using hospital episode statistics data
Follow-up
30-day readmission rates
Authors
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Associated with higher early discharge and shorter stays in unscheduled surgery; hypothesis-generating and requires randomized confirmation before practice change.
Observational
Does a surgical clinical decisions unit improve discharge rates and reduce hospital stay for unscheduled general surgery admissions?
Absolute Event Rate: 20% vs 12%
p-value: p=<0.001
A surgical clinical decisions unit improves early discharge rates and reduces hospital length of stay for unscheduled general surgery admissions without increasing readmissions.
Johnstone et al. (2015) conducted an observational in Unscheduled general surgery admissions. Surgical clinical decisions unit (CDU) vs. Prior standard care (before CDU introduction) was evaluated on Discharge within 24 hours (p=<0.001). The introduction of a surgical clinical decisions unit increased the rate of patient discharge within 24 hours (20% vs 12%, p<0.001) and decreased total hospital stay (3.2 vs 4.6 days, p<0.001).
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