In-patient hospital stays should always be minimized

Have you ever been admitted into a hospital? How long did you stay? Did you sit back to consider if the length of stay was justified? Most people dutifully occupy hospital beds for as long as advised by their clinicians. But it is increasingly recognized that prolonged hospital stays are never good for anyone. Ironically, empty hospital beds aren’t ever any good for the health facilities’ bottom lines.

Can an ideal length of stay in a hospital be defined? A simplistic answer is, yes. The length of stay must be the shortest possible, to suit each patient’s clinical parameters. Some patients will be suitable for day care, only getting admitted into hospital for a limited number of hours. Others will spill over into days, but these must be deliberately limited to the barest minimum. Anything that stretches into several days, weeks or even months must always be questioned.

For starters, nobody should ever get admitted into hospital on a whim. If you take a casual walk into any hospital, you will likely find individuals occupying hospital beds for very flimsy reasons. There are many excuses for such preposterous practices. The only reason for hospital admissions should always be clinical situations that demand close medical observations and interventions that cannot be achieved in any other way.

Let’s assume you have found yourself with a valid reason to be admitted into a hospital. Your clinical team must clearly spell out the absolute criteria that must continue to justify your stay. And such criteria must be continually reviewed. Once the point of clinical stability has been reached, you must always get out. At that point, the clinical benefit of being in a hospital bed is at its lowest. Any other day spent in hospital, sometimes justified as need for more observations, works against you in many ways. You risk additional tests and interventions, hospital acquired infections, and your bills keep adding up. You end up becoming just another patient occupying a hospital bed, adding onto the hospital’s daily bed occupancy census.

If your clinical team appear reluctant to promptly discharge you from hospital, you should always try to find out why. It may be that there is a genuine clinical reason, which must be clearly explained to you. If the reason appears wishy-washy, you shouldn’t ever accept to stay an extra day. If push ever comes to shove, and your clinical stability is as desired, you can always defy doctors’ orders and leave against medical advice.

Don’t ever get admitted into a hospital unless there wasn’t a viable alternative. Many conditions can be managed in an outpatient setting. Remote monitoring should always be considered, in addition to attendance at day centres or clinical home visits. Any hospital admissions should always be restricted to the shortest possible durations.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist. amurage@mygyno.co.ke