Strategies to improve burn center utilization.

Burn units/centers are under increasing pressure to improve resource utilization because of decreasing financial support for hospitals in general and low reimbursement for burn patients specifically. After review of occupancy and admission profiles, three strategies were implemented at the North Carolina Jaycee Burn Center to improve utilization: (1) an outreach program to attract additional burn patient referrals; (2) admission of routine plastic surgery patients to the burn center acute beds; and (3) admission of off-service ICU patients to critical care beds, depending upon availability. These strategies, especially admission of off-service ICU patients, led to an increased patient census despite an unchanged number of burn admissions and a decrease in the number of burn patient days because of earlier discharge. Policies for control of nonburn patients were essential, as were programs to educate nurses in management of other critically ill patients. These measures resulted in increased utilization and commitment of additional personnel to the burn center.