ABSTRACT 996

Abstract

Background and aims: Night time discharges are associated increased readmission morbidity and mortality. In last decade there has been increased stress on existing resources, stretching the limits during winter months. Aims: We review paediatric intensive care discharge practice with respect to the time of day. Methods: A single centre retrospective review of prospectively collected data. We compared three cohorts, 2003-05 cohort, 2006-09 and 2010-12 cohort. Night is defined between 00 -06 hours, office hours are between 08:00 - 17:00 hours, and out-of-hours (OOH) are between 17:01 and 07:59 hours. Results: Over ten year period (January2003-December2012) there were total 11,016 discharges. There is 11% increase in patient episodes in 3rd episode compared to 1st episode. (3085 Vs. 3452). 78% patients were discharged during office hours, 4% were discharged at night. Peak discharge time during year 2003-05 was mid afternoon. In cohort 2010-12 there is plateaued phase of discharges continued till late evening with missing mid afternoon peak. There is 25% increase in patients discharged during mid-night (147 Vs. 117).FigureConclusions: Total patient workload has increased over last ten years, however there is disproportionate increase in out-of-hours and night discharges. Surprisingly, office time discharges have remained same.