PRIORITY 9

What are effective alternatives to shorten length of stay for hospitalized children and youth on the general paediatric inpatient unit? (GPIU)?

Length of stay in hospital is defined as the time between admission and discharge of a patient. For children whose emotional and cognitive abilities are limited, this can be an anxiety-provoking and even traumatic experience, characterized by feelings of discomfort, fear, and loneliness.

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Gaps in Evidence

Prolonged hospitalizations can be stressful for children, youth and their families. While some evidence was identified which speaks to supporting transitional care in neonatal services, these studies tend to focus on specific care units such as the NICU and PICU. To remedy this gap, research is needed to identify ways to shorten the length of stay for hospitalized children and youth in GPIUs.

Directions for Future Research

Potential research questions and/or directions for future studies include, but are not limited to:

What challenges are associated with evening discharges (e.g. is staying overnight sometimes unnecessary)? How does time of day impact medical disposition decisions?
What standardized discharge processes can help to reduce length of stay without compromising patient safety (e.g. expected date of discharge, goals for discharge, communication to consultants regarding time of discharge)?
Which specific conditions managed on GPIUs could be safely and effectively cared for as outpatients with close follow-up care (e.g. neonatal hyperbilirubinemia, bronchiolitis, cellulitis, etc.)?
What methods of care could be implemented to shorten the length of stay without compromising patient safety (e.g. home hospitalization, late consultations by consultants, transitional care)?
How can the length of stay for patients with hyperbilirubinemia be decreased?
What existing home care services and resources could be implemented to facilitate early discharge for children with medical complexity (e.g. nursing/home resources)?