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Impact of rapid entry and accelerated care at triage on reducing emergency department patient wait times, lengths of stay, and rate of left without being seen.
Ann Emerg Med. 2005 Dec; 46(6):491-7.AE

Abstract

STUDY OBJECTIVE

Patients who leave before being seen by a physician represent a significant problem for many emergency departments (EDs). We sought to determine the effect of a new ED rapid entry and accelerated care at triage (REACT) process on the frequency of patients who leave before being seen.

METHODS

We conducted a before-after intervention design to study the effect of REACT for ambulatory patients presenting to our urban academic center ED with a census of approximately 37,000. This process redesign included patient identification tracking, integrated computer interfaces to eliminate up-front registration tasks, immediate placement of patients in open ED beds, and physician-directed ancillary testing and care at triage when no ED beds were available. Outcome measures included the average monthly rate of patients who left before being seen during the 6 months before (pre-REACT) and 6 to 12 months after (post-REACT) its initiation. Other measures included average of mean monthly rates of wait times, ED length of stay, ED census, and admissions.

RESULTS

There was a significant decrease in leave before being seen frequency from the pre-REACT to post-REACT periods (3.2% absolute decrease [95% confidence interval (CI) 1.9% to 4.6%]), despite an overall increase in ED census. Average mean monthly patient wait times decreased by 24 minutes [95% CI 10 to 38 minutes] after the initiation of REACT, as did overall ED length of stay by 31 minutes [95% CI 6 to 57 minutes].

CONCLUSION

The initiation of a rapid entry and accelerated care process significantly decreased patient leave before being seen rates, average wait times and length of stay, despite an overall increase in patient census.

Authors+Show Affiliations

Department of Emergency Medicine, University of California, Medical Center, San Diego, CA, USA. tcchan@ucsd.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16308060

Citation

Chan, Theodore C., et al. "Impact of Rapid Entry and Accelerated Care at Triage On Reducing Emergency Department Patient Wait Times, Lengths of Stay, and Rate of Left Without Being Seen." Annals of Emergency Medicine, vol. 46, no. 6, 2005, pp. 491-7.
Chan TC, Killeen JP, Kelly D, et al. Impact of rapid entry and accelerated care at triage on reducing emergency department patient wait times, lengths of stay, and rate of left without being seen. Ann Emerg Med. 2005;46(6):491-7.
Chan, T. C., Killeen, J. P., Kelly, D., & Guss, D. A. (2005). Impact of rapid entry and accelerated care at triage on reducing emergency department patient wait times, lengths of stay, and rate of left without being seen. Annals of Emergency Medicine, 46(6), 491-7.
Chan TC, et al. Impact of Rapid Entry and Accelerated Care at Triage On Reducing Emergency Department Patient Wait Times, Lengths of Stay, and Rate of Left Without Being Seen. Ann Emerg Med. 2005;46(6):491-7. PubMed PMID: 16308060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of rapid entry and accelerated care at triage on reducing emergency department patient wait times, lengths of stay, and rate of left without being seen. AU - Chan,Theodore C, AU - Killeen,James P, AU - Kelly,Donna, AU - Guss,David A, Y1 - 2005/08/18/ PY - 2005/01/21/received PY - 2005/05/19/revised PY - 2005/06/07/accepted PY - 2005/11/26/pubmed PY - 2006/2/1/medline PY - 2005/11/26/entrez SP - 491 EP - 7 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 46 IS - 6 N2 - STUDY OBJECTIVE: Patients who leave before being seen by a physician represent a significant problem for many emergency departments (EDs). We sought to determine the effect of a new ED rapid entry and accelerated care at triage (REACT) process on the frequency of patients who leave before being seen. METHODS: We conducted a before-after intervention design to study the effect of REACT for ambulatory patients presenting to our urban academic center ED with a census of approximately 37,000. This process redesign included patient identification tracking, integrated computer interfaces to eliminate up-front registration tasks, immediate placement of patients in open ED beds, and physician-directed ancillary testing and care at triage when no ED beds were available. Outcome measures included the average monthly rate of patients who left before being seen during the 6 months before (pre-REACT) and 6 to 12 months after (post-REACT) its initiation. Other measures included average of mean monthly rates of wait times, ED length of stay, ED census, and admissions. RESULTS: There was a significant decrease in leave before being seen frequency from the pre-REACT to post-REACT periods (3.2% absolute decrease [95% confidence interval (CI) 1.9% to 4.6%]), despite an overall increase in ED census. Average mean monthly patient wait times decreased by 24 minutes [95% CI 10 to 38 minutes] after the initiation of REACT, as did overall ED length of stay by 31 minutes [95% CI 6 to 57 minutes]. CONCLUSION: The initiation of a rapid entry and accelerated care process significantly decreased patient leave before being seen rates, average wait times and length of stay, despite an overall increase in patient census. SN - 1097-6760 UR - https://www.unboundmedicine.com/medline/citation/16308060/Impact_of_rapid_entry_and_accelerated_care_at_triage_on_reducing_emergency_department_patient_wait_times_lengths_of_stay_and_rate_of_left_without_being_seen_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(05)00801-2 DB - PRIME DP - Unbound Medicine ER -