The 'Length of Stay (LOS)' run-chart shows the number of days a patient was undergoing treatment or care.
• Mean acute hospital length of stay (Acute LOS): People with a hip fracture will spend some time in hospital after their operation to recover and to start their rehabilitation, usually in an acute orthopaedic, trauma or specialist hip fracture ward. This period of care is called the acute stay and is plotted on the graph as the average acute hospital length of stay for all patients discharged that month.
• Mean Trust length of stay (Trust LOS): Plots the average length of stay in the admitting hospital trust (this may be across more than one site) for all patients discharged that month. These graphs are designed to show changes in the length of stay over time, but average length of stay is often dictated by the way that services are configured in an area. As a result it is not so helpful to compare length of stay between hospitals – a hospital may have a short acute length of stay because they have good access to rehabilitation services, but this is not a measure of the proportion of patients who return to their own home.
Time spent in an emergency department or outlying wards (Emergency department/Outlier): Indicates how quickly patients reach the specialist care of the multi-disciplinary team who will lead their assessment and peri-operative care on an orthopaedic or orthogeriatric ward. This chart shows the average time a hospital’s patients spend in inappropriate settings: their time in the ED before arrival in the orthopaedic ward and/or any time spent as ‘outliers’ in other types of wards.
Note: the 'national' benchmark value will be added when there are sufficient data points to display a reasonable average trend line.
• Patients: Indicates the number of patients discharged following treatment.
Technical Summary
Definitions
Acute LOS (Days) - Time from admission to ward discharge, based on date
Trust LOS (Days) - Time from admission to trust discharge, based on date
Emergency department/Outlier (Days) - If admitted to a ward, the time-to-ward is calculated based on ward admission date/time, else if not admitted, the time to ward discharge is used.
Data Selection
The chart includes records where a patient has been discharged from either the acute ward, trust or NHS, but excluding:
records with errors (missing or erroneous data), duplicates, patients < 60 years old, exceptional care spells > 200 days to ward discharge, record conflicts.
Time Axis
The charts use 'Discharge Date' as the main monthly time-base. Patients are counted based on the year and month they were discharged from hospital trust (acute stay).
Data Calculations
Length of Stay is based on 'days' between admission and discharge, counting from the day admitted, so a patient admitted anytime on a Monday and discharged at anytime on Tuesday will count as 1 day.
Update Frequency
Chart data is recalculated every hour, but only records older than the current or previous month will be included.
Notes
In accordance with NHS information governance guidelines, we are obliged to restrict the display of 'small numbers' to avoid disclosing patient identifiable data. Therefore, this chart shows a minimum of 5 patients per month, even if the actual number of patients was lower. This adjustment is applied to the data before being displayed on the charts. We use 'midday' to calculate an 'average discharge time' since the ward discharge is date only.