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首页> 外文期刊>Canadian Journal of Emergency Medicine >A Daytime Fast Track Improves Throughput in a Single Physician Coverage Emergency Department
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A Daytime Fast Track Improves Throughput in a Single Physician Coverage Emergency Department

机译：白天快速通道可提高单个医师覆盖范围急诊室的吞吐量

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ObjectivesFast tracks are one approach to reduce emergency department (ED) crowding. No studies have assessed the use of fast tracks in smaller hospitals with single physician coverage. Our study objective was to determine if implementation of an ED fast track in a single physician coverage setting would improve wait times for low-acuity patients without negatively impacting those of higher acuity.MethodsA daytime fast track opened in 2010 at Strathroy Middlesex General Hospital, a southwestern Ontario community hospital. Before and after intervention groups comprised of ED visits in 2009 and 2011 were compared. Pooled comparison of all Canadian Triage and Acuity Scale (CTAS) patients in each period, and between subgroups CTAS 2-5 comparisons were performed for: wait time (WT), length of stay (LOS), WTs that met national CTAS time guidelines (MNCTG), and proportion of patients that left without being seen (LWBS).ResultsWT and LOS were six minutes (88 min to 82 min, p=0.002) and 15 minutes (158 min to 143 min, p<0.001) lower, respectively, in the post-intervention period. Subgroup analysis showed CTAS 4 had the most pre- to post-intervention decrease in WT, of 13 minutes (98 min to 85 min, p<0.001). There was statistical improvement in MNCTG in the post-intervention period. No differences were found in outcome measures for higher-acuity patients or LWBS rates.ConclusionsImplementation of a fast track in a medium-volume community hospital with single physician coverage can improve patient throughput by decreasing WT and LOS without negatively impacting high-acuity patients. This may be clinically relevant, particularly for hospital administrators, given the improvement in meeting national WT standards we found post-intervention.
机译：目标快速跟踪是减少急诊科（ED）拥挤的一种方法。没有研究评估在单人医师覆盖的小型医院中使用快速通道的情况。我们的研究目标是确定在单一医师覆盖范围内实施ED快速通道是否会改善低视力患者的等待时间，而不会对较高视力的患者产生负面影响。方法2010年在Strathroy Middlesex General Hospital开设的日间快速通道安大略省西南部社区医院。比较了2009年和2011年由急诊科就诊的干预组前后。每个时期内所有加拿大分流和敏锐度评分（CTAS）患者以及亚组之间CTAS 2-5的汇总比较进行了以下比较：等待时间（WT），住院时间（LOS），符合国家CTAS时间指南的WTs（结果（WT）和LOS分别降低了6分钟（88分钟至82分钟，p = 0.002）和15分钟（158分钟至143分钟，p <0.001） ，在干预后期间。亚组分析显示，CTAS 4干预前至干预后WT降低幅度最大，为13分钟（98分钟至85分钟，p <0.001）。干预后的时期，MNTCG有统计学上的改善。结论：在中型社区医院中采用单医生覆盖率的快速通道可以通过降低WT和LOS来提高患者通量，而不会对高敏患者产生负面影响。考虑到在干预后满足国家WT标准的情况有所改善，这在临床上可能是相关的，尤其是对于医院管理人员。

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