The average length of stay at St Luke's Hospital is low in spite of the large number of social cases who have a tendency to occupy beds for long periods, according to the results of a benchmarking exercise announced by Health Minister Louis Deguara yesterday.
The exercise was conducted at St Luke's, two of Malta's private hospitals - St James and Capua - and a large public hospital in Dublin - St James Hospital.
The Dublin hospital was chosen because it had collaborated with St Luke's on other projects in the past, had similar cultural backgrounds, was of comparative size and had a similar specialisation mix.
The study found that although St Luke's was efficient at carrying out certain activities, there was room for improvement in other areas.
St Luke's also had comparatively high levels of activity for admissions, thereby generating a very large throughput and a high annual rate of operations that continued to increase each year.
The minister said the exercise, which started a year ago, was "a detailed comparison of the processes affecting bed utilisation".
"This part of the exercise showed that there is considerable room for improvement in the way in which we actually admit patients to hospital, and discharge them. The need to strengthen our primary care sector was highlighted in this exercise."
The chief executive officer of the new Mater Dei Hospital, Kenneth Grech, said the exercise was aimed at reviewing the utilisation of inpatient beds at St Luke's in preparation for the migration to the Mater Dei in 2005.
The purpose of the exercise was to facilitate a consistent and continuously improving approach in the management of clinical and non-clinical processes and resources to meet the need of patients requiring elective and emergency care as well as day care services.
The exercise found that St Luke's had a high admission rate of 52,000 patients per year, 45 per cent of whom were emergency cases.
The average bed occupancy rate was 80 per cent although in some areas it went up to between 100 and 110 per cent. This showed that the hospital had to rethink its bed distribution.
The average length of stay at St Luke's was 4.7 days, lower than that of its overseas partner.
Dr Grech said the exercise established that although the patient administration system at St Luke's Hospital generated important information, it required further enhancement.
There was no designated bed management function with a centralised booking and admitting office while discharge planning started and ended on the day of discharge.
The exercise recommended the implementation of a patient classification system that enabled appropriate coding of medical and surgical procedures, the setting up of a bed management bureau for coordination of admissions and for monitoring the hospital bed activity and the appointment of a designated manager with total responsibility for bed management.
Dr Grech said the report, which is to be discussed with hospital staff next month, stressed the importance of support from the authorities and the commitment of stakeholders. Restructuring and reorganisation had to be addressed from both the regulatory and providers' perspectives.
The group managing director at St James and Capua hospitals, Josie Muscat, proposed further cooperation between the hospitals, especially in areas where there were long waiting lists.
The deputy chief executive of St James in Ireland, Ian Carter, said that as a result of the exercise, St Luke's hosted an international benchmarking conference on Thursday and yesterday with the participation of representatives of 12 hospitals from England, Belgium, Wales, the Netherlands, Ireland, Northern Ireland and Australia.
It was the first conference of its kind in Europe looking at how things were done in the different hospitals and why, giving the different hospitals the golden opportunity to change practices.