Reducing the length of hospital stay for older adults admitted to hospital for planned treatment: A systematic review of the evidence

Reducing the length of hospital stay

Status: Complete

Briefing Paper: We have produced a 4-page Briefing paper and a comic which summerises the project and the main findings.

The Exeter Evidence Synthesis Centre were asked to review the evidence on strategies that hospitals use to reduce the length of time older adults spend in hospital following a planned inpatient stay.

This page provides some information about the background of this project, how the team carried out the research and why we had members of the public to have a say on how the project was carried out.

Background
Adults over 60 years of age who are admitted to hospital for planned treatment may be at greater risk of complications, both during the treatment they receive and their hospital stay afterwards. Examples of such complications include: infection, pressure sores, loss of mobility, poor nutrition and dehydration and reduced feelings of wellbeing. These complications may slow down a patient’s recovery and delay their discharge from hospital. This is not something which patients, their families or their carers want and risks putting increased demand on the National Health Service.

As a result, it is important that hospitals have effective strategies to ensure timely discharge and reduction of excessive length of stay for older adults.

Aims of our project
We aimed to assess the effectiveness of different strategies used by hospitals to reduce the length of stay of people over the age of 60 admitted for planned treatments or procedures. This will be used to inform guidance for hospital managers, commissioners and clinical teams on how to improve patient recovery from elective surgery, reduce the time patients need to spend in hospital and suggest potential areas for further research.

Research questions
1.    What is the effectiveness of hospital-based strategies which aim to reduce the length of inpatient stay for older adults following a planned admission?
2.    What is the value for money of hospital-based strategies which aim to reduce length of inpatient stay in hospitals for older adults following planned admission?

What we did
We carried out something known as a systematic review. This involved bringing together the findings of lots of different studies to find out what is already known about different hospital based strategies which aim to reduce the time older adults need to spend in hospital.

How we did it
We searched different online libraries for all the research papers which have been written about this topic and searched the references lists of these papers. We then filtered out the ones that did not meet our selection criteria.

We will then took out the information we needed from the relevant papers identified by our searches. This information included;
-    The age of the people being treated in hospital,
-    What type of treatment they are receiving,
-    The strategy the hospital use to keep their length of stay as short as possible
-    The number of days people spend in hospital.
-    Any complications people experience during their stay in hospital or if they are readmitted after being discharged.

We brought this information together in a way which best answered our two research questions. For more detailed information about how we did this, please see our project protocol here.

Involving Patients and the Public
We wanted to make sure that our review is relevant to patients and that its findings make sense.
Therefore, we discussed the review with a group of adults aged 60 or above who have experience of being admitted to hospital for a planned treatment or procedure. We also asked patient’s partners and carers for their views. Together, along with separate meetings with health professionals, this helped us to analyse our results and share our findings.

We met with these different groups of people 2-3 times over 8 months, whilst we carried out the project.

Sharing our results
We shared our findings of our research to the relevant people, including hospital managers, doctors, nurses, patients and families.

You can listen to our podcast on our blog to learn more about what we found.

Alternatively, you may like to read the full report, found here:  https://doi.org/10.3310/hsdr07400

If you have any feedback or comments about this review, please email:
Liz Shaw: E.H.Shaw@exeter.ac.uk or Jo Thompson Coon: J.Thompson-Coon@exeter.ac.uk