Shorten The Average Such Confinement To Patients In Hospital Process Research

Objective:This paper uncovers the existing problems and common reasons of surgical patients with an average length of stay by analyzing the present business process. The aim of the paper is intend to reduce the economic burden of patients, improve hospital efficiency, and provide a reference proposal of controlling the average length of stay for hospital administrators by optimizing the transformation of the original hospitalization process.Methods:Assess hospitalization procedure of leiomyoma surgery, cholelithiasis surgery, and inguinal hernia surgery patients’fifity case histories respectively from Jan1to Dec12in2010, in a three level of first-class hospital of Taiyuan. Firstly, using Delphi Method to map out the surgical hospitalization flowchart; secondly, collecting data of length of stay, hospital costs in the process by retrospective study, and to assess their need for length of stay and appropriateness of patient days by Business Process Reengineering and Appropriateness Evaluation Protocol, Using EXCEL software for entry and sort, and SPSS13.0software for Paired T-test statistical analysis.Results:1. Surgery hospitalization process is divided into:complete medical records (admission), some wait for the check, waiting for test results, waiting for surgery, preoperative preparation, continue to wait for surgery, surgery, and postoperative recovery, can be discharged (discharged).2. Using BPR and AEP optimize reorganize hospital process, the average dates of three types of surgery staved in the hospital have shortened (p<0.001). The average dates of the patients staved in the hospital for leiomyoma surgery have decreased1.94days, preoperative length of stay of1.00days shorter and postoperative hospital stay was0.94days shorter; The average dates of the patients staved in the hospital for cholelithiasis surgery have decreased1.64days, preoperative length of stay of0.58days shorter and postoperative hospital stay was1.06days shorter; The average dates of the patients staved in the hospital for inguinal hernia surgery have decreased1.72days, preoperative length of stay of0.68days shorter and postoperative hospital stay was1.04days shorter.3. Using BPR and AEP optimize reorganize hospital process, the average cost of three types of surgery staved in the hospital have shortened (p<0.001). The average cost of the patients staved in the hospital for leiomyoma surgery have reduced by340.81RMB, preoperative hospitalization costs have reduced by141.80RMB and postoperative hospitalization costs have reduced by199.01RMB:The average cost of the patients staved in the hospital for cholelithiasis surgery have reduced by596.52RMB, preoperative hospitalization costs have reduced by191.96RMB and postoperative hospitalization costs have reduced by404.56RMB; The average cost of the patients staved in the hospital for inguinal hernia surgery have reduced by472.43RMB, preoperative hospitalization costs have reduced by170.66RMB and postoperative hospitalization costs have reduced by301.77RMB;4. After Optimization reorganization, as three disease species increase in the number of patients who are admitted to, hospital annual income has also increased. Leiomyoma surgery patients increase42cases by year and Annual income of the hospital increase308526.66RMB; cholelithiasis surgery patients increase32cases by year and Annual income of the hospital increase239290.64RMB; inguinal hernia surgery patients increase34cases by year and Annual income of the hospital increase149248.98RMB.Conclusion:1. In this study, the hospital process bottleneck of shorten the average length of stay as follows:Standards of patients who admitted are not uniform; various waiting time is such long; Projects and the completion time of diagnosis and treatment services especially after surgery are always different and Standards of patients who discharged are not uniform.2. Transforming process for patients by using management method can shorten the average length of stay, reduce the burden of patients, accelerate bed turnover, and increase the number of patients. It is beneficial to both patients and hospital.