Predictor Tool to Fast Track and Reduce

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Use of Predictor Tool To Fast track and Reduce Prof Celia Tan, SingHealth post TKR Length of Stay in Acute Hospital Dr Jasper Tong, SingHealth Tang Wen Han, SingHealth Dr Darren Tay, Singapore General Hospital Eleanor Chew, Singapore General Hospital Grace Lim, Singapore General Hospital Nur Raudhah Binte Azimat, Singapore General Hospital May Kyawt Aung, Singapore General Hospital Christopher Teo, Bright Vision Hospital Prof Lee Kheng Hock, Bright Vision Hospital To reduce the length of stay in Singapore General Hospital for post surgical Total Knee Replacement (TKR) Patients requiring intensive therapy, using a predictive tool to identify them at pre-operation day. Patients are fast tracked from acute to community hospital for longer term rehabilitation needs. 272 out of 1900 TKR cases were discharged April Feb to the community hospital in 2015 2016 2017 The average LOS of patients discharged to community hospitals is 8.6, which is longer than the average LOS for TKR patients at 5.4. Average LOS for CH Fast Track LOS 2 main reasons for the delay placement (1) referral processing delay and (2) bed availability All healthcare team inputs Subsequent delay in bed required for referral preparation and patient submission transfer Completed only on POD 4 Bed, Physiotherapy 72 patients, 223.2 bed days Pre- Operation Using the predictive tool to identify patients requiring longer rehabilitation has allowed us to successfully reduce the LOS in an acute hospital by fast tracking or arranging for early discharge to a community hospital. 1 Prediction for LOS 2 Discharge Counselling Operation Day Early identification of patients is a useful method to help stratify patient’s needs, reduce cost for the patient and optimise hospital Fast Track Referral + resources for appropriate care. We have successfully reduced the 3 Bed Preparation length of stay for those fast tracked. Immediate Acceptance POD 4 / 5 The fast track has been implemented in 3 partner community hospitals (Bright Vision Hospital, Jurong Community Hospital and Yishun Community Hospital), and will be extended to more Patient Transferred to CH community hospitals. .

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