The impact of a fast track area on quality and effectiveness outcomes: a Middle Eastern emergency department perspective.

Hdl Handle:
http://hdl.handle.net/10147/94486
Title:
The impact of a fast track area on quality and effectiveness outcomes: a Middle Eastern emergency department perspective.
Authors:
Devkaran, Subashnie; Parsons, Howard; Van Dyke, Murray; Drennan, Jonathan; Rajah, Jaishen
Affiliation:
Royal College of Surgeons in Ireland, Dubai Healthcare City, Dubai, United Arab Emirates. subashnie_d@hotmail.com
Citation:
The impact of a fast track area on quality and effectiveness outcomes: a Middle Eastern emergency department perspective. 2009, 9:11 BMC Emerg Med
Journal:
BMC emergency medicine
Issue Date:
2009
URI:
http://hdl.handle.net/10147/94486
DOI:
10.1186/1471-227X-9-11
PubMed ID:
19534787
Abstract:
BACKGROUND: Emergency department (ED) overcrowding is a ubiquitous problem with serious public health implications. The fast track area is a novel method which aims to reduce waiting time, patient dissatisfaction and morbidity. |The study objective was to determine the impact of a fast track area (FTA) on both effectiveness measures (i.e. waiting times [WT] and length of stay [LOS]) and quality measures (i.e. LWBS rates and mortality rates) in non-urgent patients. The secondary objective was to assess if a FTA negatively impacted on urgent patients entering the ED. METHODS: The study took place in a 500 bed, urban, tertiary care hospital in Abu Dhabi, United Arab Emirates. This was a quasi-experimental, which examined the impact of a FTA on a pre-intervention control group (January 2005) (n = 4,779) versus a post-intervention study group (January 2006) (n = 5,706). RESULTS: Mean WTs of Canadian Triage Acuity Scale (CTAS) 4 patients decreased by 22 min (95% CI 21 min to 24 min, P < 0.001). Similarly, mean WTs of CTAS 5 patients decreased by 28 min (95% CI 19 min to 37 min, P < 0.001) post FTA. The mean WTs of urgent patients (CTAS 2/3) were also significantly reduced after the FTA was opened (P < 0.001). The LWBS rate was reduced from 4.7% to 0.7% (95% CI 3.37 to 4.64; P < 0.001). Opening a FTA had no significant impact on mortality rates (P = 0.88). CONCLUSION: The FTA improved ED effectiveness (WTs and LOS) and quality measures (LWBS rates) whereas mortality rate remained unchanged.
Language:
en
Keywords:
GENERAL AND ACUTE SERVICES, ACCIDENT AND EMERGENCY
MeSH:
Efficiency, Organizational; Emergency Service, Hospital; Female; Hospital Mortality; Hospitals, Urban; Humans; Length of Stay; Male; Outcome Assessment (Health Care); Patient Satisfaction; Quality of Health Care; Retrospective Studies; Time and Motion Studies; United Arab Emirates
ISSN:
1471-227X

Full metadata record

DC FieldValue Language
dc.contributor.authorDevkaran, Subashnieen
dc.contributor.authorParsons, Howarden
dc.contributor.authorVan Dyke, Murrayen
dc.contributor.authorDrennan, Jonathanen
dc.contributor.authorRajah, Jaishenen
dc.date.accessioned2010-03-18T11:57:42Z-
dc.date.available2010-03-18T11:57:42Z-
dc.date.issued2009-
dc.identifier.citationThe impact of a fast track area on quality and effectiveness outcomes: a Middle Eastern emergency department perspective. 2009, 9:11 BMC Emerg Meden
dc.identifier.issn1471-227X-
dc.identifier.pmid19534787-
dc.identifier.doi10.1186/1471-227X-9-11-
dc.identifier.urihttp://hdl.handle.net/10147/94486-
dc.description.abstractBACKGROUND: Emergency department (ED) overcrowding is a ubiquitous problem with serious public health implications. The fast track area is a novel method which aims to reduce waiting time, patient dissatisfaction and morbidity. |The study objective was to determine the impact of a fast track area (FTA) on both effectiveness measures (i.e. waiting times [WT] and length of stay [LOS]) and quality measures (i.e. LWBS rates and mortality rates) in non-urgent patients. The secondary objective was to assess if a FTA negatively impacted on urgent patients entering the ED. METHODS: The study took place in a 500 bed, urban, tertiary care hospital in Abu Dhabi, United Arab Emirates. This was a quasi-experimental, which examined the impact of a FTA on a pre-intervention control group (January 2005) (n = 4,779) versus a post-intervention study group (January 2006) (n = 5,706). RESULTS: Mean WTs of Canadian Triage Acuity Scale (CTAS) 4 patients decreased by 22 min (95% CI 21 min to 24 min, P < 0.001). Similarly, mean WTs of CTAS 5 patients decreased by 28 min (95% CI 19 min to 37 min, P < 0.001) post FTA. The mean WTs of urgent patients (CTAS 2/3) were also significantly reduced after the FTA was opened (P < 0.001). The LWBS rate was reduced from 4.7% to 0.7% (95% CI 3.37 to 4.64; P < 0.001). Opening a FTA had no significant impact on mortality rates (P = 0.88). CONCLUSION: The FTA improved ED effectiveness (WTs and LOS) and quality measures (LWBS rates) whereas mortality rate remained unchanged.-
dc.language.isoenen
dc.subjectGENERAL AND ACUTE SERVICES, ACCIDENT AND EMERGENCYen
dc.subject.meshEfficiency, Organizational-
dc.subject.meshEmergency Service, Hospital-
dc.subject.meshFemale-
dc.subject.meshHospital Mortality-
dc.subject.meshHospitals, Urban-
dc.subject.meshHumans-
dc.subject.meshLength of Stay-
dc.subject.meshMale-
dc.subject.meshOutcome Assessment (Health Care)-
dc.subject.meshPatient Satisfaction-
dc.subject.meshQuality of Health Care-
dc.subject.meshRetrospective Studies-
dc.subject.meshTime and Motion Studies-
dc.subject.meshUnited Arab Emirates-
dc.titleThe impact of a fast track area on quality and effectiveness outcomes: a Middle Eastern emergency department perspective.en
dc.contributor.departmentRoyal College of Surgeons in Ireland, Dubai Healthcare City, Dubai, United Arab Emirates. subashnie_d@hotmail.comen
dc.identifier.journalBMC emergency medicineen

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