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Triage-based resource allocation and clinical treatment protocol on outcome and length of stay in the emergency department.
Emerg Med Australas. 2015 Aug; 27(4):328-35.EM

Abstract

OBJECTIVE

The present study aimed to determine the relationship between the triage-based resource allocation and clinical treatment (TRACT) protocol and mortality and length of stay (LOS) in ED.

METHODS

This before-and-after study was conducted in an adult, tertiary, teaching hospital ED from August 2008 to July 2012. Patients who were younger than 18 years of age, who were dead on arrival and whose triage information was not available were excluded. TRACT was implemented in August 2010, and the Emergency Severity Index (ESI) was used for triage. Primary and secondary outcomes were ED mortality and ED LOS. Multivariate logistic regression models for ED mortality and multivariable general linear models on the ED LOS were used to compare the before- and after-intervention periods.

RESULTS

For the 155 563 visits over study period, the ED mortality rate was 0.2%, and the ED LOS was 4.6 h (median). The adjusted odds ratios (95% confidence intervals [CIs]) of the TRACT protocol on ED mortality were 0.69 (0.54-0.88) for total patients, 0.42 (0.30-0.59) for ESI 1, 1.04 (0.66-1.65) for ESI 2 and 1.45 (0.76-2.75) for ESI 3 group. The adjusted coefficients (95% CIs) of the TRACT on the ED LOS were -88.1 (-96.9 ∼ -79.2) min for all patients, -44.9 (-72.0 ∼ -17.9) min for ESI level 2 and -104.3 (-114.7 ∼ -94.0) min for ESI level 3.

CONCLUSIONS

The TRACT protocol decreased the ED mortality in ESI 1 group and reduced the ED LOS in ESI levels 2 and 3 groups.

Authors+Show Affiliations

Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Seoul, Korea.Department of Emergency Medicine, Gachon University Gil Hospital, Gyeonggi, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26075591

Citation

Ro, Young Sun, et al. "Triage-based Resource Allocation and Clinical Treatment Protocol On Outcome and Length of Stay in the Emergency Department." Emergency Medicine Australasia : EMA, vol. 27, no. 4, 2015, pp. 328-35.
Ro YS, Shin SD, Song KJ, et al. Triage-based resource allocation and clinical treatment protocol on outcome and length of stay in the emergency department. Emerg Med Australas. 2015;27(4):328-35.
Ro, Y. S., Shin, S. D., Song, K. J., Cha, W. C., & Cho, J. S. (2015). Triage-based resource allocation and clinical treatment protocol on outcome and length of stay in the emergency department. Emergency Medicine Australasia : EMA, 27(4), 328-35. https://doi.org/10.1111/1742-6723.12426
Ro YS, et al. Triage-based Resource Allocation and Clinical Treatment Protocol On Outcome and Length of Stay in the Emergency Department. Emerg Med Australas. 2015;27(4):328-35. PubMed PMID: 26075591.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Triage-based resource allocation and clinical treatment protocol on outcome and length of stay in the emergency department. AU - Ro,Young Sun, AU - Shin,Sang Do, AU - Song,Kyoung Jun, AU - Cha,Won Chul, AU - Cho,Jin Sung, Y1 - 2015/06/15/ PY - 2015/05/14/accepted PY - 2015/6/16/entrez PY - 2015/6/16/pubmed PY - 2016/4/23/medline KW - crowding KW - emergency department KW - mortality KW - triage SP - 328 EP - 35 JF - Emergency medicine Australasia : EMA JO - Emerg Med Australas VL - 27 IS - 4 N2 - OBJECTIVE: The present study aimed to determine the relationship between the triage-based resource allocation and clinical treatment (TRACT) protocol and mortality and length of stay (LOS) in ED. METHODS: This before-and-after study was conducted in an adult, tertiary, teaching hospital ED from August 2008 to July 2012. Patients who were younger than 18 years of age, who were dead on arrival and whose triage information was not available were excluded. TRACT was implemented in August 2010, and the Emergency Severity Index (ESI) was used for triage. Primary and secondary outcomes were ED mortality and ED LOS. Multivariate logistic regression models for ED mortality and multivariable general linear models on the ED LOS were used to compare the before- and after-intervention periods. RESULTS: For the 155 563 visits over study period, the ED mortality rate was 0.2%, and the ED LOS was 4.6 h (median). The adjusted odds ratios (95% confidence intervals [CIs]) of the TRACT protocol on ED mortality were 0.69 (0.54-0.88) for total patients, 0.42 (0.30-0.59) for ESI 1, 1.04 (0.66-1.65) for ESI 2 and 1.45 (0.76-2.75) for ESI 3 group. The adjusted coefficients (95% CIs) of the TRACT on the ED LOS were -88.1 (-96.9 ∼ -79.2) min for all patients, -44.9 (-72.0 ∼ -17.9) min for ESI level 2 and -104.3 (-114.7 ∼ -94.0) min for ESI level 3. CONCLUSIONS: The TRACT protocol decreased the ED mortality in ESI 1 group and reduced the ED LOS in ESI levels 2 and 3 groups. SN - 1742-6723 UR - https://www.unboundmedicine.com/medline/citation/26075591/Triage_based_resource_allocation_and_clinical_treatment_protocol_on_outcome_and_length_of_stay_in_the_emergency_department_ L2 - https://doi.org/10.1111/1742-6723.12426 DB - PRIME DP - Unbound Medicine ER -