This week the SCoOP report was published. Otherwise known as the Acute Hospital Outcomes Report 2017/18; it provides an overview of the outcomes of acute geriatric medicine services in Scotland and is published by Scottish Care of Older People National Audit Project which amongst other things is trying to evaluate the variation in service provision for older people who require health and social care in various settings, to serve as a driver for standardisation and improvement of care across Scotland.
They have reported that admissions to geriatric medical wards in Scotland’s 19 largest hospitals with major emergency departments have risen by 10% for three consecutive years, reaching 43,311 in 2017/18.
The report has also concluded the length of stay dropped across all sites by an average of one day over the same period.
More concerningly they have noted the number of admissions varied widely across sites in Scotland, with some areas showing large increases in activity while others are in decline. There was also a large variation in the typical length of time patients spent in different hospitals. In some cases, there were up to 12-fold differences in the length of stay, while hospitals with higher activity levels usually had lower lengths of stay.
There was also a strong relationship between the time waiting to get to a specialist bed and the overall length of time patients spent in hospital; suggesting that delays in accessing specialist services contribute markedly to longer stays in hospital.
Differences in readmission rates and mortality were less marked between hospitals, broadly remaining stable over the last three years.
The report does not attempt to explain the variations but aims to stimulate discussion, learning and action that could be used to help benchmark some key patient outcomes and encourage interorganisational learning.
Professor Graham Ellis, Co-Chair of SCoOP Steering Group and the National Clinical Lead for Older People, Healthcare Improvement Scotland said:
“The wider goal is to reduce unwarranted and unjustifiable variation in outcomes, which may represent a threat to patient safety and/or a failure to learn from best practice.”