Answer “yes” or “no” for each question in relation to this patient | 1 | Is any intervention going to take place TODAY that required the patient to be hospitalised all day yesterday for evaluation or pre-op preparation? |
2 | Did the patient receive surgery, cardiac catherisation, angiography, biopsy of any internal organ, thoracocentesis, paracentesis or invasive procedures of the central nervous system YESTERDAY or THE DAY BEFORE YESTERDAY? |
3 | Did the patient experience incapacity to urinate and/or defecate (not attributable to neurological problems or chronic constipation) YESTERDAY or THE DAY BEFORE YESTERDAY? |
4 | Were any tests performed YESTERDAY that required strict diet control? Was the patient monitored by a doctor (>3 visits/day)? Was the patient taking any new (or experimental) treatment requiring frequent dose adjustments under direct medical supervision? |
5 | Did the patient receive respiratory therapy and/or mechanical ventilation through inhalation (at least three times a day) YESTERDAY? Did s/he receive any form of parenteral therapy? i.m. or s.c. injections (at least 2 times per day, excluding insulin)? |
6 | YESTERDAY, were the patient’s vital sign monitored (at least every 30 minutes during at least 4 hours)? Was his/her water equilibrium corrected with medication? Did the patient require monitoring (at least 3 times/day under medical supervision)? Did the patient receive treatment for surgical wounds and/or draining? |
7 | YESTERDAY or THE DAY BEFORE YESTERDAY did the patient receive any transfusions? Did s/he present ventricular fibrilation or was acute ischaemia evidenced with ECG? Did the patient have a fever (>38° rectal) that was not related to the cause of admission? Was the patient in a coma or with acute confusion? Were there signs of acute haematological alterations? Did the patient present progressive neurological difficulties? |
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If you answered “no” to all of the questions, it is likely that from a strictly medical standpoint, and without taking into consideration problems related to the family or organisational logistics, etc, this patient would not have needed to remain hospitalised yesterday. Do you believe that for CLINICAL REASONS this patient needs to remain hospitalised? (yes/no) |
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If you answered “no” to the previous question, the patient’s stay is due to (check reason): | 1 | Problems of programing diagnostic tests |
2 | Problems of programing surgery |
3 | Premature admission |
4 | Problems with the patient or family |
5 | Responsibility of the hospital: organisational problems with discharge |
6 | Lack of alternative care (overnight facilities, hospital-at-home, etc) |
7 | Responsibility of the doctor: excessively conservative length of stay as part of patient management |
8 | Others (specify): |