Tags

Type your tag names separated by a space and hit enter

Emergency department crowding is associated with poor care for patients with severe pain.
Ann Emerg Med. 2008 Jan; 51(1):1-5.AE

Abstract

STUDY OBJECTIVE

We study the impact of emergency department (ED) crowding on delays in treatment and nontreatment for patients with severe pain.

METHODS

We performed a retrospective cohort study of all patients presenting with severe pain to an inner-city, teaching ED during 17 months. Poor care was defined by 3 outcomes: not receiving treatment with pain medication while in the ED, a delay (>1 hour) from triage to first pain medication, and a delay (>1 hour) from room placement to first pain medication. Three validated crowding measures were assigned to each patient at triage. Logistic regression was used to test the association between crowding and outcomes.

RESULTS

In 13,758 patients with severe pain, the mean age was 39 years (SD 16 years), 73% were black, and 64% were female patients. Half (49%) of the patients received pain medication. Of those treated, 3,965 (59%) experienced delays in treatment from triage and 1,319 (20%) experienced delays from time of room placement. After controlling for factors associated with the ED treatment of pain (race, sex, severity, and older age), nontreatment was independently associated with waiting room number (odds ratio [OR] 1.03 for each additional waiting patient; 95% confidence interval [CI] 1.02 to 1.03) and occupancy rate (OR 1.01 for each 10% increase in occupancy; 95% CI 0.99 to 1.04). Increasing waiting room number and occupancy rate also independently predicted delays in pain medication from triage (OR 1.05 for each waiting patient, 95% CI 1.04 to 1.06; OR 1.18 for each 10% increase in occupancy; 95% CI 1.15 to 1.21) and delay in pain medication from room placement (OR 1.02 for each waiting patient, 95% CI 1.01 to 1.03; OR 1.06 for each 10% increase in occupancy, 95% CI 1.04 to 1.08).

CONCLUSION

ED crowding is associated with poor quality of care in patients with severe pain, with respect to total lack of treatment and delay until treatment.

Authors+Show Affiliations

Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. pinesjes@uphs.upenn.edu.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17913299

Citation

Pines, Jesse M., and Judd E. Hollander. "Emergency Department Crowding Is Associated With Poor Care for Patients With Severe Pain." Annals of Emergency Medicine, vol. 51, no. 1, 2008, pp. 1-5.
Pines JM, Hollander JE. Emergency department crowding is associated with poor care for patients with severe pain. Ann Emerg Med. 2008;51(1):1-5.
Pines, J. M., & Hollander, J. E. (2008). Emergency department crowding is associated with poor care for patients with severe pain. Annals of Emergency Medicine, 51(1), 1-5.
Pines JM, Hollander JE. Emergency Department Crowding Is Associated With Poor Care for Patients With Severe Pain. Ann Emerg Med. 2008;51(1):1-5. PubMed PMID: 17913299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergency department crowding is associated with poor care for patients with severe pain. AU - Pines,Jesse M, AU - Hollander,Judd E, Y1 - 2007/10/25/ PY - 2007/04/24/received PY - 2007/06/21/revised PY - 2007/07/05/accepted PY - 2007/10/5/pubmed PY - 2008/1/18/medline PY - 2007/10/5/entrez SP - 1 EP - 5 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 51 IS - 1 N2 - STUDY OBJECTIVE: We study the impact of emergency department (ED) crowding on delays in treatment and nontreatment for patients with severe pain. METHODS: We performed a retrospective cohort study of all patients presenting with severe pain to an inner-city, teaching ED during 17 months. Poor care was defined by 3 outcomes: not receiving treatment with pain medication while in the ED, a delay (>1 hour) from triage to first pain medication, and a delay (>1 hour) from room placement to first pain medication. Three validated crowding measures were assigned to each patient at triage. Logistic regression was used to test the association between crowding and outcomes. RESULTS: In 13,758 patients with severe pain, the mean age was 39 years (SD 16 years), 73% were black, and 64% were female patients. Half (49%) of the patients received pain medication. Of those treated, 3,965 (59%) experienced delays in treatment from triage and 1,319 (20%) experienced delays from time of room placement. After controlling for factors associated with the ED treatment of pain (race, sex, severity, and older age), nontreatment was independently associated with waiting room number (odds ratio [OR] 1.03 for each additional waiting patient; 95% confidence interval [CI] 1.02 to 1.03) and occupancy rate (OR 1.01 for each 10% increase in occupancy; 95% CI 0.99 to 1.04). Increasing waiting room number and occupancy rate also independently predicted delays in pain medication from triage (OR 1.05 for each waiting patient, 95% CI 1.04 to 1.06; OR 1.18 for each 10% increase in occupancy; 95% CI 1.15 to 1.21) and delay in pain medication from room placement (OR 1.02 for each waiting patient, 95% CI 1.01 to 1.03; OR 1.06 for each 10% increase in occupancy, 95% CI 1.04 to 1.08). CONCLUSION: ED crowding is associated with poor quality of care in patients with severe pain, with respect to total lack of treatment and delay until treatment. SN - 1097-6760 UR - https://www.unboundmedicine.com/medline/citation/17913299/Emergency_department_crowding_is_associated_with_poor_care_for_patients_with_severe_pain_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(07)01297-8 DB - PRIME DP - Unbound Medicine ER -