Reducing length of stay in patients following liver transplantation using the model for continuous improvement
Length of stay (LOS) is a significant contributor to overall patient outcomes for patients undergoing liver transplantation. This study documents a quality improvement project aiming to reduce the median post-transplant LOS for liver transplant patients. We instituted five Plan–Do–Study–Act cycles w...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-03-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/12/1/e002149.full |
| _version_ | 1797870956104908800 |
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| author | Alan Gob Mayur Brahmania Anton Skaro Yashasavi Sachar Abdulrhman Alamr Ephraim Tang Anouar Teriaky Karim Qumosani Corinne Weernink Melanie Dodds Kelly Thomas Lynne Sinclair |
| author_facet | Alan Gob Mayur Brahmania Anton Skaro Yashasavi Sachar Abdulrhman Alamr Ephraim Tang Anouar Teriaky Karim Qumosani Corinne Weernink Melanie Dodds Kelly Thomas Lynne Sinclair |
| author_sort | Alan Gob |
| collection | DOAJ |
| description | Length of stay (LOS) is a significant contributor to overall patient outcomes for patients undergoing liver transplantation. This study documents a quality improvement project aiming to reduce the median post-transplant LOS for liver transplant patients. We instituted five Plan–Do–Study–Act cycles with the goal of reducing LOS by 3 days from a baseline median of 18.4 days over 1 year. Balancing measures such as readmission rates ensured any decrease in stay was not associated with significantly increased patient complications. Over the 28-month intervention period and 24-month follow-up period, there were 193 patients discharged from hospital with a median LOS of 9 days. The changes appreciated during quality improvement interventions carried over to sustained improvements, with no significant variability in LOS postintervention. Discharge within 10 days increased from 18.4% to 60% over the study period, with intensive care unit stay decreasing from a median of 3.4–1.9 days. Thus, the development of a multidisciplinary care pathway, with patient engagement, led to improved and sustained discharge rates with no significant differences in readmission rates. |
| first_indexed | 2024-04-10T00:35:32Z |
| format | Article |
| id | doaj.art-adf77f316ba74a1ba3a676ce52c58d14 |
| institution | Directory Open Access Journal |
| issn | 2399-6641 |
| language | English |
| last_indexed | 2024-04-10T00:35:32Z |
| publishDate | 2023-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj.art-adf77f316ba74a1ba3a676ce52c58d142023-03-14T17:30:11ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-03-0112110.1136/bmjoq-2022-002149Reducing length of stay in patients following liver transplantation using the model for continuous improvementAlan Gob0Mayur Brahmania1Anton Skaro2Yashasavi Sachar3Abdulrhman Alamr4Ephraim Tang5Anouar Teriaky6Karim Qumosani7Corinne Weernink8Melanie Dodds9Kelly Thomas10Lynne Sinclair11Center for Quality, Innovation and Safety, Western University, London, Ontario, CanadaDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, CanadaDepartment of General Surgery, Western University, London, Southeastern Ontario, CanadaDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, CanadaDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, CanadaDepartment of General Surgery, Western University, London, Southeastern Ontario, CanadaDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, CanadaDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, CanadaDepartment of General Surgery, Western University, London, Southeastern Ontario, CanadaDepartment of General Surgery, Western University, London, Southeastern Ontario, CanadaDepartment of General Surgery, Western University, London, Southeastern Ontario, CanadaDepartment of General Surgery, Western University, London, Southeastern Ontario, CanadaLength of stay (LOS) is a significant contributor to overall patient outcomes for patients undergoing liver transplantation. This study documents a quality improvement project aiming to reduce the median post-transplant LOS for liver transplant patients. We instituted five Plan–Do–Study–Act cycles with the goal of reducing LOS by 3 days from a baseline median of 18.4 days over 1 year. Balancing measures such as readmission rates ensured any decrease in stay was not associated with significantly increased patient complications. Over the 28-month intervention period and 24-month follow-up period, there were 193 patients discharged from hospital with a median LOS of 9 days. The changes appreciated during quality improvement interventions carried over to sustained improvements, with no significant variability in LOS postintervention. Discharge within 10 days increased from 18.4% to 60% over the study period, with intensive care unit stay decreasing from a median of 3.4–1.9 days. Thus, the development of a multidisciplinary care pathway, with patient engagement, led to improved and sustained discharge rates with no significant differences in readmission rates.https://bmjopenquality.bmj.com/content/12/1/e002149.full |
| spellingShingle | Alan Gob Mayur Brahmania Anton Skaro Yashasavi Sachar Abdulrhman Alamr Ephraim Tang Anouar Teriaky Karim Qumosani Corinne Weernink Melanie Dodds Kelly Thomas Lynne Sinclair Reducing length of stay in patients following liver transplantation using the model for continuous improvement BMJ Open Quality |
| title | Reducing length of stay in patients following liver transplantation using the model for continuous improvement |
| title_full | Reducing length of stay in patients following liver transplantation using the model for continuous improvement |
| title_fullStr | Reducing length of stay in patients following liver transplantation using the model for continuous improvement |
| title_full_unstemmed | Reducing length of stay in patients following liver transplantation using the model for continuous improvement |
| title_short | Reducing length of stay in patients following liver transplantation using the model for continuous improvement |
| title_sort | reducing length of stay in patients following liver transplantation using the model for continuous improvement |
| url | https://bmjopenquality.bmj.com/content/12/1/e002149.full |
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