Managing Longstayers in NTFGH
Care Process & Redesign
National University Health System Quality Improvement
National University Health System
31 December 2023
To achieve a 30% reduction in total bed days for long-staying patients (>21 days) in General Medicine by Dec 2022. Managing longstayers improved bed utilization, reduced costs, and enhanced discharge planning processes.
Year Submitted: 2023
Published Date: 31 December 2023
Tags: Care Process ＆ Redesign, Value Based Care, Length Of Stay, Discharge Planning, Quality Improvement, Workflow Redesign
About this Content
Aims
To achieve a 30% reduction in total bed days for long-staying patients (>21 days) in General Medicine by Dec 2022.
Background
Longstayers (3% of inpatients) occupied 25% of NTFGH’s beds, with 74% under General Medicine. Causes included inconsistent discharge goals, delayed investigations, and poor communication.
Methods
PDSA cycles implemented: standardized Expected Discharge Date (EDD), patient consolidation to specific wards, and multidisciplinary meetings for patients >21 days.
Results
Achieved 36% reduction in bed days in pilot wards (C7, C8, C9), saving 564 bed days monthly. Sustained improvements continued into FY23.
Conclusion
Managing longstayers improved bed utilization, reduced costs, and enhanced discharge planning processes.
Lessons Learnt
Multidisciplinary collaboration and system-level changes ensured sustainability. Frequent reviews and leadership support drove project success.
Additional Information
Results were scaled hospital-wide with EDD integrated into Medicine KPIs.
Keywords
Longstayer Reduction, Discharge Planning, Bed Utilization, Multidisciplinary Collaboration, PDSA Cycles, General Medicine, Workflow Redesign, NTFGH
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | Ng Teng Fong General Hospital |
Platform(s) | National University Health System Quality Improvement |
Healthcare Professional Group(s) | Allied Health, Nursing, Medical |
Applicable Specialty or Discipline | General Medicine, Physiotherapy, Medical Social Workers |
Project Lead(s) | Poon Yoke Chen |
Project Member(s) | Pang Lu Kiat |
Connect with this contributor!
Pang Lu Kiat - pang_lu_kiat@nuhs.edu.sg