Implementing the intensity of care model in a surgical department: an evaluation

The authors' hospital implemented an intensity of care model in the surgical department, grouping patients by the level of care they required (low, high or intensive) and creating a short-stay unit for patients requiring a low level of care. This study evaluated care quality, along with staff and patient perceptions, in the department 3 years after this model was implemented. Data were collected from mandatory national databanks regarding organisation, economic, staff and patient factors relating to care quality and efficiency. The department's performance according to National Outcome Programme indicators was also assessed. Data from staff and patient satisfaction questionnaires used for routine audit were analysed retrospectively. Both questionnaires asked respondents to rate their satisfaction to items on a 5-point Likert scale so their scores could be analysed. Satisfaction scores for staff in the short-stay unit were compared with those working in general surgery using a t-test, with P<0.05 indicating a significant difference. Some improvements were found 3 years after the model was implemented, including increased elective activity and reduced length of stay. Patient satisfaction with the short-stay unit was generally high. However, staff satisfaction was generally low and turnover rates were high. The intensity of care model and the use of a short-stay unit can lead to benefits for surgical care, but further research is needed to determine its effects on all aspects of care quality and, especially, staff satisfaction.