A PREDISCHARGE WARD FOR ACUTE MEDICAL PATIENTS

We describe and evaluate a ward developed to facilitate the discharge planning of general medical patients. Description: A 15-bed pre-discha rge ward (PDW) with a ward coordinator was established in 1995, as a c ounterpoise to a medical assessment unit (MAU). Method: Data, analysed after the first year, included diagnosis, physiotherapy and occupatio nal therapy referrals, length of stay and discharge destination.Result s: During its first year, 810 patients were admitted to the PDW; 39% w ere male, their mean age was 75 years (range, 16-99; standard deviatio n, 11.3). Respiratory illness (24%) was the commonest diagnosis, 62% r equired physiotherapy, 51% occupational therapy and 35% needed increas ed social support. Discharge was as follows: 681 (84.1%) patients were discharged to their admission address, 34 (4.2%) were taken over by t he department for care of the elderly, 29 (3.6%) discharged to relativ es, 23 (2.8%) to residential or nursing homes, 22 (2.7%) returned to a cute medical beds, 12 (1.5 %) to general practitioner beds and nine pa tients (1.1%) died. The average length of stay during a three-month pe riod (October-December) for all acute medical patients was 7.47 days b efore the MAU and PDW were opened and 7.32 days afterwards. Conclusion : The PDW provides multidisciplinary assessment and focused discharge planning for patients of general physicians. This did not prolong thei r stay in acute medical beds.