Appropriate Admissions

Appropriate Admissions

Up to 40% of hospital admissions from A&E departments in the UK could be avoided, but factors such as unavailability of appropriate intermediate care or time delays in getting lab results back, can mean an unnecessary admission is required.

Primary care trusts (PCTs) undoubtedly have strong financial incentives to reduce the number of people being admitted to hospital with conditions that ideally would not warrant an inpatient stay. Benchmarking individual performance against the national trends is important, as it can help identify those PCTs which have been most successful in reducing these numbers.

But, when it comes to making improvements in this area, which problems
should you tackle first and what effect should your actions ideally have?
Optimising patient flow and limiting avoidable admissions is essential to deliver efficient, timely treatment for patients and make full use of hospital resources. Real-time recording and analysis of patient admissions provides the opportunity for hospitals to be aware of the number of avoidable admissions and the reasons behind them, thereby enabling them to take the necessary action to reduce these numbers.

ExtraMed’s Avoidable Admission system accurately records all admissions through A&E and the reasons behind them. At present there is no alternative system which provides a real-time integrated solution to these problems.

Reports generated by the software provide an analysis of both avoidable
and necessary admissions and split them into time of day, day of the week, and the admitting consultant; this eliminates the need for manual data capture by staff. The Appropriate Admissions system is part of the Hospital Intelligence web-based solutions, which also offers a range of useful patient flow data including Breach Analysis.

The module is an additional part of the process currently available with ExtraMed’s A&E Whiteboard, which is presently being utilised in six NHS hospitals throughout the UK. The system allows the hospital to optimise
their patient flow and identify, track and manage patients to avoid four hour breaches.

The technology allows staff to fill in a very simple form taking seconds, which can then provide a whole host of data to clinicians and managers for further analysis. The Avoidable Admission system seeks to give staff a real-time view of all admissions, whether they are avoidable or not, whilst the Breach Analysis aims to provide staff with important information regarding the time a patient spent in A&E and any reasons for delays.

“Avoidable Admissions should be a priority for every trust and PCT management team. Improving appropriateness optimises the use of resources – improves patient care, reduces complaints, improves performance and can seriously reduce costs. Most health economies would be surprised at their current levels of unnecessary admissions. This is an area where easy improvements can be made quickly,” Patrick Kelly, director of client
services, ExtraMed Ltd.

It is important to know what actions work best at a local level and to analyse appropriate data with local knowledge and understanding. The Audit Commission is discussing with those PCTs who have exhibited the most significant reductions, what it was that led to these changes. ExtraMed is working with PCTs, clinicians and managers to generate these vital reports and find solutions for the ongoing problems faced on busy wards.