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Module 4 - Learning Packages for Health Record Practice

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Module 4 - Learning Packages for Health Record Practice

    Appendix 2

     Appendix 2 Answer Key to Appendix 1

    Education Module 4 Healthcare Statistics

    EXERCISE 1 Patient Care Unit CENSUS

1. Using the information from the left of the page, complete the daily census for patient unit

    A.

UNIT A DAILY CENSUS FOR DATE 6.3.06

John Smith adm. from a. No. on unit last report 40

    O.P.D. (Dr. Richard)

Adam James adm. Dr. Maurice No. admitted 5

Stanley Paul adm. G.P. No. transfers in 1

Anthony Greech trans. b. Total 6

    from other hospital

Patrick Sterling trans. No. discharges 5

    from Med. (Ward B)

Gordon Thompson died 10.30 a.m. No. Deaths 2

Wayne Johnson emerg. adm. No. transfers out 1

Brett Arnold disch. O.P.D. c. Total 8

Michael Stephens disch. G.P.

Adam Carpenter trans. Today's census

    to Psych. (Ward D) a + b - c = 40 + 6 - 8 = 38

John Trip trans. to

    other hospital

Wayne Johnson died 4.30 p.m.

John Smith disch. O.P.D.

Thomas Adams disch. O.P.D.

2. Number of patient days for patient unit A on 6-3-06: 40

    38 + 2 patients admitted and discharged on 6-3-06 = 40

     1

    Appendix 2

     EXERCISE 2 - HOSPITAL CENSUS REPORT

    Date: 6-3-06

Complete the data for Unit A from Exercise 1.

Complete the Hospital Census report.

What checks for accuracy can you use?

     Prev. Admi- Transfers Discharges Transfers Today's Unit Day ssions In Out Census Alive Deaths Census 1 from B A 40 5 5 2 1 to D 38 B 35 4 2 from C 1 to A 41 C 23 8 4 2 to B 25 D 28 3 1 from A 2 1 28 E 30 6 3 33 TOTA156 26 4 14 3 4 165

    L

Accuracy checks:

1. Total transfers in equal total transfers out

2. Today's hospital census is result of adding total admissions and transfers in to previous

    day census, and subtracting from this the total discharges and transfers out.

    156 + 26 + 4 - 14 - 3 - 4 = 165

     2

    Appendix 2

     EXERCISE 3 - HOSPITAL CENSUS

Complete today's hospital census report

    HOSPITAL CENSUS REPORT

    August 27, 2006.

     Prev. Admi- Transfers Discharges Transfers Today's Unit Day ssions In Out Census Discharges Deaths Census A 40 3 2 2 to B 39 B 26 2 from A 4 1 1 to D 22 C 31 8 2 from D 5 1 35 D 45 1 from B 10 2 to C 34 E 12 6 18 TOTAL 154 17 5 21 2 5 148

     3

    Appendix 2

     EXERCISE 4

1. Compute the length of stay of 10 patients who were discharged from hospital on October

    6, 2006. Their dates of admission were as follows:

    (a) September 12 24 (f) September 11 25

    (b) September 28 8 (g) October 5 1

    (c) September 30 6 (h) September 16 20

    (d) September 26 10 (i) October 6 1

    (e) October 4 2 (j) August 13 54

(k) What was the average LOS? 15.1 151 divided by 10

2. In a 200 bed hospital, the patient days for 2006 were 62,050. The 6,495 patients who

    were discharged or died had a total of 61,930 days care. Using the above figures,

    compute the following averages and rates, showing formulae used.

(a) 62050 divided by 365 = 170 patients

(b) (62050 x 100) divided by (200 x 365) = 85.0%

(c) 61930 divided by 6495 = 9.54 or 9.5 days

     4

    Appendix 2

    EXERCISE 5

1. A Coronary Care Unit in a large teaching hospital had a total bed count of 20 beds in

    2006. During the year the patient days for the unit were calculated at 5,260 days. The 1,255 inpatients who were discharged from the unit during 2006 spent a total of 5,066 days there.

    (a) 5260 divided by 365 = 14.41 or 14 patients

    (b) 5066 divided by 1255 = 4.03 or 4.0 days

    (c) (5260 x 100) divided by (20 x 365) = 72.054 or 72.1%

2. The following data have been collected from a 700 bed general hospital during 2006:

    Patients admitted 14,117

    Total discharges/deaths 14,086

    Total discharge days 137,202

    Total inpatient patient days 226,842

    Total registered outpatient attendances 192,846

    From the information above, calculate the following, showing formulae:-

    (a) 137202 divided by 14086 = 9.74 or 9.7 days

    (b) 226842 divided by 365 = 621.48 or 622 patients

    (c) (226842 x 100) divided by (700 x 365) = 88.78 or 88.8%

3. In a local hospital, the average length of stay in January 2006 was 10.4 days. The

    number of patient days care rendered to discharged patients in the same period was 5,460. How many discharges were there in January?

     5460 divided by 10.4 = 525 discharges/deaths

4. A 460 bed general hospital assigned 215 beds for general medical service, 125 beds for

    general surgery including Orthopedics, the remainder, 120, were divided among the other services. For the past 12 months (2004) the number of patient days within the three major categories were:

    Pt. days Beds Bed days

    A. General medicine 59,059 215 x 365 78690

    B. General surgery 43,070 125 x 365 45750

    C. Other services 35,040 120 x 365 43920

    Using the above information calculate the following for each of the three categories:

    General Medicine General Surgery Other Services

    (i) 5905900/78690= 75.1% 4307000/45750 = 94.1% 3504000/43920 = 79.8%

    (ii) 59059/365 = 161.36 or 161 43070/365 = 117.67 or 118 35040/365 = 95.73 or 96

     5

    Appendix 2

    EXERCISE 6

A 477 bed general hospital had 15,746 patients discharged/died in 2006. Total deaths for the

    year were 487. There were 81 cases reported to the Coroner, and 351 autopsies were

    performed.

Total patient days were 136,995 and the total length of stay of discharged/died patients was

    136,540.

Give the formulae, and using the above information, compute the following:

1. (487 x 100) divided by 15746 = 3.09 or 3.1%

2. 15746 divided by 477 = 33.01 or 33.0

3. (351 x 100) divided by (487 - 81) = 86.453 or 86.5%

    (The 81 Coroner's cases were NOT autopsied at the hospital)

4. 136450 divided by 15746 = 8.67 or 8.7 days

     6

    Appendix 2

    EXERCISE 7

    1. The following data have been collected from a local hospital. The average length of stay

    in June was 5.2 days. The total length of stay of discharged/died patients in the same period was 2,730. There were 18 deaths, including 2 unautopsied Coroner's cases and 12 autopsies were performed.

a. Number of patients discharged/died = 525

    (18 x 100) divided by 525 = 3.43 or 3.4%

    b. (12 x 100) divided by (18 - 2) = 75.0% (.0 for uniformity with other indicators)

    2. The following data have been collected from a 700 bed general hospital during 2006.

Patients admitted 19,957

    Total discharges/deaths 19,933

    Patients remaining in hospital midnight

    Dec.31, 2005 632 Patients remaining in hospital midnight

    Dec.31, 2004 656 Total length of stay of discharged/died patients 218,515

    Total patient days 236,842

    Total deaths 615

    Total autopsies performed 485

    Coroner's cases (unautopsied) 43

    Number of anaesthetics administered 6,925

    Number of operations performed 7,700

    Total registered outpatients 192,846

From the information above, calculate the following:

a. 236842 divided by 365 = 648.88 or 649 patients

b. (615 x 100) divided by 19933 = 3.08 or 3.1%

c. (700 x 365) - 236842 divided by 19933 = 0.93 or 0.9 days

d. (485 x 100) divided by 615 = 78.86 or 78.9%

e. (485 x 100) divided by (615 - 43) = 84.79 or 84.8%

f. (236842 x 100) divided by (700 x 365) = 92.69 or 92.7%

g. 218515 divided by 19933 = 10.96 or 11.0 days (.0 added for uniformity)

     7

    Appendix 2

    EXERCISE 8

    The following information was collected from a 500 bed hospital and includes the census figures for the 30th September, 2006 and the monthly figures for the month of September, 2004.

(a) September 30

    Patients in hospital at midnight 418

    Patients discharged 30th September 17

    Patients admitted 30th September 24

    (6 patients were admitted and discharged

    the same day.)

(b) September 2004

    Total number of discharges/deaths 1088

    Total deaths 43

    Coroner's Cases (unautopsied) 4

    Total number of autopsies performed 28

    Total number of anaesthetics administered 467

    Total number of outpatient attendances 16203

    Total patient days during September 12332

    Total length of stay of discharged/died

    patients 10943

From the above figures, calculate the following:-

1. Census for the 30th September 418 - 17 + 24 = 425

2. Patient days for 30th September 425 + 6 = 431

3. 12332 divided by 30 = 411.06 or 411 patients

4. (12332 x 100) divided by (500 x 30) = 82.21 or 82.2%

5. 10943 divided by 1088 = 10.06 or 10.1 days

6. (28 x 100) divided by 43 = 65.12 or 65.1%

7. 1088 divided by 500 = 2.18 or 2.2

8. (43 x 100) divided by 1088 = 3.95 or 4.0%

9. (28 x 100) divided by (43 - 4) = 71.79 or 71.8%

     8

    Appendix 2

    EXERCISE 9

1. In an obstetric hospital there were 310 live births in June 2004; of this number 7 died

    within the early neonatal period. The hospital also registered 8 fetal deaths for the same

    month. What rates were calculated below?

a. (8 + 7) x 100 divided by (310 + 8) = 4.72 or 4.7% Perinatal death rate

b. 8 x 100 divided by (310 + 8) = 2.52 or 2.5% Fetal death

2. An obstetric hospital published the following figures in 2004.

Obstetrical discharges

    ? delivered 2288

    ? undelivered 327

    ? aborted 39

    Total infants discharged/died 2255

    Total births (live) 2309

    Infant deaths (early neonatal) 56

    Fetal deaths 36

    Maternal deaths 3

Using the above information, calculate the following:

a. 3 x 100 divided by (2299 + 327 + 139) = 0.1%

b. 56 x 100 divided by 2255 = 2.48 or 2.5%

c. 36 x 100 divided by (2309 + 36) = 1.54 or 1.5%

d. (36 + 56) x 100 divided by (2309 + 36) = 3.92 or 3.9%

    3. A 320 bed obstetric hospital had 10,220 obstetric separations in 2006. There were 7,016

    live births; 139 fetal deaths; 523 caesarean sections were performed with a total of 6,968

    deliveries for the year and 2 maternal deaths. There were 4 infant deaths classed as

    early neonatal. Using the above information, calculate the following:

a. 139 x 100 divided by (7016 + 139) = 1.94 or 1.9%

b. 523 x 100 divided by 6968 = 7.51 or 7.5%

c. (139 + 4) x 100 divided by (139 + 7016) = 1.99 or 2.0%

    It is not reasonable to have only 4 infant deaths. The medical record professional

    should investigate to be sure that infants who die minutes after birth are not being

    classified as fetal deaths.

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    Appendix 2

    EXERCISE 10

You have received the following medical statistics for review prior to their publication in the

    Annual Report of a General Hospital. What comments do you have regarding the accuracy of

    the data?

Available beds (Bed complement) 430

    Total admissions 11,285

    Total discharges/deaths 11,123

    Total deaths 521

    Patients in hospital at midnight on 31 December 2003 344

    Patients in hospital at midnight on 31 December 2004 371

    Autopsies performed (including 2 autopsied Coroner's Cases) 378

    Coroner's cases 44

    Total patient days 128,954

    Total length of stay of discharged/died patients 126,872

    Out-patient visits 106,750

There is an inconsistency in the inpatient data. If there were 344 patients in hospital at the

    beginning of the year and 11,285 admissions and 11,123 discharges/deaths, there would be

    506 patients remaining at the end of the year which is impossible given that the hospital has

    430 beds. 344 + 11285 - 11123 = 506

    Average daily census 352 Divided by 365 rather than 366 Percentage of Occupancy 81.9%

    Turnover rate 25.9

    Hospital death rate 46.8% Multiplied by 1000 rather than 100 Gross autopsy rate 0.73% Did not multiply by 100 Net autopsy rate 0.79% Did not multiply by 100

     10

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