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Rapid medical assessment: improving pediatric emergency department time to provider, length of stay, and left without being seen rates.
Pediatr Emerg Care. 2012 Apr; 28(4):354-6.PE

Abstract

OBJECTIVES

This article aimed to study the impact of a rapid medical assessment (RMA) program on patient flow and left without being seen (LWBS) rates in a pediatric emergency department (ED). RMA is designed to evaluate and discharge uncomplicated patients quickly or initiate diagnostic workup and treatment before the patient is placed in an ED bed.

METHODS

Rapid medical assessment was initiated January 1, 2008 with an assigned midlevel provider. We compared 6 months of data from January 1 to June 30, 2007 (pre-RMA), to January 1 to June 30, 2008 (post-RMA). Data studied were obtained from a tracking system and include the time to provider, ED length of stay, and the LWBS rate. t Test was used to compare results, and χ test was used to compare LWBS rates.

RESULTS

During the study period, there were 28,360 patients seen in 2007 and 32,053 in 2008. Time to provider mean time was 80 minutes (median = 57) in 2007 and 53 minutes (median = 39) in 2008, with a difference of 27 minutes (95% confidence interval, 25-28 minutes). Mean length of stay in 2007 was 239 minutes (median = 220) compared to 181 minutes (median = 162) in 2008, with a difference of 58 minutes (95% confidence interval, 56-60 minutes). The LWBS rate decreased from 9% in 2007 to 3% in 2008 (χ P < 0.01).

CONCLUSIONS

Rapid medical assessment is an effective way to improve patient flow and reduce the LWBS rate. A decrease in the LWBS rate allows the ED to provide health care to these potentially high-risk patients.

Authors+Show Affiliations

Department of Emergency Medicine, University of California, Davis, Sacramento, CA 95817, USA. vwtsai@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22453731

Citation

Tsai, Virginia W., et al. "Rapid Medical Assessment: Improving Pediatric Emergency Department Time to Provider, Length of Stay, and Left Without Being Seen Rates." Pediatric Emergency Care, vol. 28, no. 4, 2012, pp. 354-6.
Tsai VW, Sharieff GQ, Kanegaye JT, et al. Rapid medical assessment: improving pediatric emergency department time to provider, length of stay, and left without being seen rates. Pediatr Emerg Care. 2012;28(4):354-6.
Tsai, V. W., Sharieff, G. Q., Kanegaye, J. T., Carlson, L. A., & Harley, J. (2012). Rapid medical assessment: improving pediatric emergency department time to provider, length of stay, and left without being seen rates. Pediatric Emergency Care, 28(4), 354-6. https://doi.org/10.1097/PEC.0b013e31824d9d27
Tsai VW, et al. Rapid Medical Assessment: Improving Pediatric Emergency Department Time to Provider, Length of Stay, and Left Without Being Seen Rates. Pediatr Emerg Care. 2012;28(4):354-6. PubMed PMID: 22453731.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid medical assessment: improving pediatric emergency department time to provider, length of stay, and left without being seen rates. AU - Tsai,Virginia W, AU - Sharieff,Ghazala Q, AU - Kanegaye,John T, AU - Carlson,Lesley Ann, AU - Harley,Jim, PY - 2012/3/29/entrez PY - 2012/3/29/pubmed PY - 2012/8/15/medline SP - 354 EP - 6 JF - Pediatric emergency care JO - Pediatr Emerg Care VL - 28 IS - 4 N2 - OBJECTIVES: This article aimed to study the impact of a rapid medical assessment (RMA) program on patient flow and left without being seen (LWBS) rates in a pediatric emergency department (ED). RMA is designed to evaluate and discharge uncomplicated patients quickly or initiate diagnostic workup and treatment before the patient is placed in an ED bed. METHODS: Rapid medical assessment was initiated January 1, 2008 with an assigned midlevel provider. We compared 6 months of data from January 1 to June 30, 2007 (pre-RMA), to January 1 to June 30, 2008 (post-RMA). Data studied were obtained from a tracking system and include the time to provider, ED length of stay, and the LWBS rate. t Test was used to compare results, and χ test was used to compare LWBS rates. RESULTS: During the study period, there were 28,360 patients seen in 2007 and 32,053 in 2008. Time to provider mean time was 80 minutes (median = 57) in 2007 and 53 minutes (median = 39) in 2008, with a difference of 27 minutes (95% confidence interval, 25-28 minutes). Mean length of stay in 2007 was 239 minutes (median = 220) compared to 181 minutes (median = 162) in 2008, with a difference of 58 minutes (95% confidence interval, 56-60 minutes). The LWBS rate decreased from 9% in 2007 to 3% in 2008 (χ P < 0.01). CONCLUSIONS: Rapid medical assessment is an effective way to improve patient flow and reduce the LWBS rate. A decrease in the LWBS rate allows the ED to provide health care to these potentially high-risk patients. SN - 1535-1815 UR - https://www.unboundmedicine.com/medline/citation/22453731/Rapid_medical_assessment:_improving_pediatric_emergency_department_time_to_provider_length_of_stay_and_left_without_being_seen_rates_ L2 - https://doi.org/10.1097/PEC.0b013e31824d9d27 DB - PRIME DP - Unbound Medicine ER -