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    The referral and complete evaluation time study.

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    Authors
    Gilligan, Peadar
    Winder, Stephen
    Ramphul, Navin
    O'kelly, Patrick
    Affiliation
    Departments of aEmergency bInformation Technology cNephrology, Beaumont Hospital, Dublin, Ireland. peadargilligan@beaumont.ie
    Issue Date
    2010-12
    
    Metadata
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    Citation
    The referral and complete evaluation time study. 2010, 17 (6):349-53 Eur J Emerg Med
    Journal
    European journal of emergency medicine : official journal of the European Society for Emergency Medicine
    URI
    http://hdl.handle.net/10147/126573
    DOI
    10.1097/MEJ.0b013e328337b9f1
    PubMed ID
    20389251
    Abstract
    It has been suggested that inefficiency in the delivery of care in emergency departments (EDs) may contribute to their overcrowding. Specifically the duplication of work by the on take teams of the assessment already performed by the ED doctor has been identified as a possible contributor to prolonged waits for a hospital bed for those requiring admission. Anything that prolongs an individual patient's processing time will contribute to overcrowding.
    This observational study was performed using a database of all patient attendances to examine the timeliness of the delivery of care to patients requiring admission through the ED and specifically to examine the impact of the referral process on the total time spent in the ED.
    Between August 2006 and February 2007, 6973 (25.4%) patients were referred to the on take teams and admitted. The mean total time in the ED for the 4092 (58.7%) medical patients was 21 h 16 min (standard deviation 12 h 24 min) as compared with 14 h 28 min (standard deviation 10 h 46 min) for the 2852 (40.9%) surgical admissions (P<0.001). The referral process accounted for an average of 16.6% of the patient journey through the ED while access block accounted for an average of 59.6%.
    The overwhelming reason for prolonged waits and overcrowding in Irish EDs is not the duplication of work inherent in the referral process but it is because of a lack of acute hospital capacity.
    Item Type
    Article
    Language
    en
    ISSN
    1473-5695
    ae974a485f413a2113503eed53cd6c53
    10.1097/MEJ.0b013e328337b9f1
    Scopus Count
    Collections
    Beaumont Hospital

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