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The Impact of a Temporary Medical Ward Closure on Emergency Department and Hospital Service Delivery Outcomes

Crilly, Julia PhD, MN (Hons), RN; Keijzers, Gerben MB BS, MSc (Epi), FACEM; Krahn, Dirken MB BS (State med. exam, Marburg); Steele, Michael PhD; Green, David MB BS, FACEM; Freeman, Janeen BNursing (Grad Cert. Public Health Management)

doi: 10.1097/QMH.0b013e318231355a
Original Articles

Objective: To describe the effect of a 3-week closure of a 28-bed medical ward on Emergency Department (ED) and hospital outcomes.

Methods: This was a prospective comparative observational study of all ED attendances (visits; n = 11 383) made to a regional teaching hospital in Queensland, Australia, during a 9-week period (November 24, 2008–January 4, 2009). A 3-week period of ward closure was compared with equal time periods before and after. Hospital health information systems data were linked manually to describe and compare outcomes: median ED length of stay, access block, hospital length of stay, and in-hospital mortality.

Results: Ward closure reduced hospital bed capacity by 5.9%. During ward closure there was a higher proportion of access block (38% vs 33% in both pre- and posttimes), longer wait time to see a doctor, and longer overall ED length of stay, compared with pre–ward closure time period.

Conclusion: Temporarily closing a medical ward had a negative effect on some ED and hospital outcomes. When major refurbishments are required, alternative capacity measures need to be considered to minimize the impact on health service delivery and patient outcomes. Reducing elective surgery and opening replacement beds elsewhere in the hospital are possible solutions.

Emergency Department Clinical Network (Drs Crilly and Green), Department of Emergency Medicine (Drs Keijzers, Green and Krahn), and Division of Medicine (Ms Freeman), Gold Coast Hospital, Queensland, Australia; Griffith Health Institute (Drs Green and Crilly), Griffith University, Queensland, Australia; Faculty of Business (Dr Steele), Faculty of Health Science and Medicine (Drs Keijzers and Steele) Bond University, Gold Coast, Queensland, Australia.

Correspondence: Julia Crilly, PhD, MN (Hons), RN, Emergency Department, Gold Coast Hospital, 108 Nerang St, Southport, Queensland 4215, Australia (julia_crilly@health.qld.gov.au).

The authors thank the Decision Support Services staff and Ms Nerolie Bost from the Gold Coast Hospital for their assistance with this study.

There were neither supporting sources nor any financial or professional relationships that would pose as a competing interest. There was no specific funding for this research.

The authors declare no conflict of interest.

©2011Lippincott Williams & Wilkins, Inc.