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Clinical Research
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Minimizing Length of Stay: How one facility saved time, Money and Improved Woundcare Outcomes with a Subtle Change to Protocol First Author: Sandra Jonjo Authors: Sandra Jonjo, BSN, BSMGT BACKGROUND: Skin breakdown accounts for numerous painful dressing changes, hours of medical personnel time, increased healthcare cost and increased length of stay (LOS). It is estimated that skin breakdown affects 1.7 million persons per year and cost approximately 3.1 billion dollars.1 One large metropolitan hospital instituted an effort to decrease LOS and cut costs for fiscal year 2006. The wound care nurse developed a quality improvement project to decrease length of stay, improve wound care and decrease cost. Three diagnosis related groups (DRG) that reflect skin and woundcare were selected to monitor (Code 263, 271 & 277). METHODOLOGY: Wound care protocols were reviewed and new anti-microbial dressings* were introduced in place of standard dressings. The selected antimicrobial dressings were proven to prevent bacterial penetration through and inhibited growth within the dressing. It was hypothesized that the dressing could help control bacteria and provide a better wound healing environment thus reducing the average LOS. The dressings were utilized exactly as the standard dressings had been and no other changes in woundcare protocol were implemented at this time. CONCLUSIONS: After implementing anti-microbial dressings the hospital's cumulative average LOS for three DRGs showed a 10% reduction compared to the previous year; also the facilities LOS was 38% better than the national expectation. LOS avoidance was 68 days versus prior and 375 lower than the national benchmark. The reduction in LOS resulted in estimated, gross savings of almost $36,000 versus prior and $200,000, for these 119 patients2. This information is statistically significant: DRG codes 263 and 271 showed a 1 in 1000 probability that the difference was due to chance; for DRG code 277 there was a 1 in 100 probability that the difference was due to chance |
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