Grant: Partnerships for Health System Improvement (PHSI)

Hospitalizations are common (over 1 million per year in Canada) and due to over-crowding of hospitals and their emergency rooms, there has been increasing pressure to discharge patients as soon as possible during hospitalizations. However, up to one fifth of patients discharged from medical wards return to hospital within 30 days. In addition to negatively impacting on patient quality of life, such readmissions contribute substantially to increased wait times and over-crowding in emergency rooms. In the fall of 2010, a number of changes were made to the way in which care was delivered for patients hospitalized on General Internal Medicine wards at the University of Alberta Hospital ("the GIM Care Transformation Initiative"). These changes were designed to optimize in hospital care and improve the processes of transitioning back to the community at the time of discharge. Using data routinely collected by Alberta Health Services, we plan to compare how individuals were managed and how they fared (in terms of length of stay, mortality, repeat hospitalizations, and emergency room visits) before and after implementation of the GIM Care Transformation Initiative in a hospital where the initiative was implemented (the University of Alberta Hospital) and in 6 other teaching hospitals in Edmonton and Calgary where the initiative was not implemented.