ObjectiveWe evaluated the usefulness of a short stay or 23-hour ward in a pediatric unit of a large teaching hospital, Westmead Hospital, and an academic Childrenrsquo;s hospital, The New Childrenrsquo;s Hospital, to determine if they are a useful addition to the emergency service.MethodsThis is a descriptive comparison of prospectively collected data on all children admitted to the short stay ward at Westmead Hospital (WH) during 1994 and the short stay ward at the New Childrenrsquo;s Hospital (NCH) during 1997ndash;98. These hospitals service an identical demographic area with the latter (NCH) a tertiary referral center. The following outcome measures were usedcolon; length of stay, appropriateness of stay, rate of admission to an in-hospital bed, and rate of unscheduled visits within 72 hours of discharge. Adverse events were reported and patient follow-up was attempted at 48 hours after discharge in all cases.ResultsThe short stay ward accounted for 10.3percnt; (Westmead Hospital) and 14.7percnt; (New Childrenrsquo;s Hospital) of admissions, with 56percnt; medical in nature, 30percnt; surgical, and the remainder procedural or psychological. Admission patterns were similar, with asthma, gastroenteritis, convulsion, pneumonia, and simple surgical conditions accounting for most short stay ward admissions. The short stay ward increased hospital efficiency with an average length of stay of 17.5 hours (Westmead Hospital) compared to 20.5 hours (New Childrenrsquo;s Hospital). The users of the short stay ward were children of young age less than 2 years, with stay greater than 23 hours reported in only 1percnt; of all admissions to the short stay ward. The rate of patient admission to an in-hospital bed was low, (4percnt; lsqb;Westmead Hospitalrsqb; compared to 6percnt; lsqb;New Childrenrsquo;s Hospitalrsqb;), with the number of unscheduled visits within 72 hours of short stay ward discharge less than 1percnt;. There were no adverse events reported at either short stay ward, with parental satisfaction high. The short stay ward was developed through reallocation of resources from within the hospital to the short stay ward. This resulted in estimated savings of $1/2 million (Westmead Hospital) to $2.3 million (New Childrenrsquo;s Hospital) to the hospital, due to more efficient bed usage.ConclusionThis data demonstrates the robust nature of the short stay ward. At these two very different institutions we have shown improved bed efficient and patient care in a cost-effective way. We have also reported on greater parental satisfaction and early return of the child with their family to the community.
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