4.5 Article

A descriptive study on reasons for prolonged hospital stay in a tertiary hospital in Singapore

Journal

JOURNAL OF NURSING MANAGEMENT
Volume 29, Issue 7, Pages 2307-2313

Publisher

WILEY
DOI: 10.1111/jonm.13360

Keywords

care coordination; case management; delayed discharge; discharge issues; discharge planning; length of stay; patient navigator; prolonged hospital stay

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This study identified the top reasons for prolonged hospital stay among medically unfit and fit patients, providing insights for healthcare resource optimization.
Background Our health care is facing with the challenges of bed crunch and increasing number of patients with prolonged hospital stay. Aims This study aimed to determine factors contributing to the prolonged hospital stay in a tertiary hospital in Singapore. Methods A random sample of 600 medical records of patients' staying in hospital for more than 21 days was retrieved. The reasons for their prolonged hospital stay were categorized into 'medically unfit' and 'medically fit'. Results The top three reasons for prolonged hospital stay among the 'medically unfit' group were ongoing medical treatment, surgical interventions and receiving intravenous chemotherapy/radiotherapy. The top three reasons for the 'medically fit' group were waiting for community hospital bed, waiting for a new caregiver and undecided on discharge disposition. Conclusion The results inform health care stakeholders in planning measures to minimize the incidence of unnecessary prolonged hospitalization for optimal health care resource utilization. Implications of Nursing Management Ineffective discharge planning can lead to serious adverse outcomes such as hospital readmission and prolonged hospital stay. Patient navigators have a crucial role in facilitating safe, smooth and timely discharge of patients from acute care hospital to community. Understanding the reasons behind extended hospitalization is essential in order to better provide support.

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