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The association between ambulance hospital turnaround times and patient acuity, destination hospital, and time of day.

机译：救护车医院周转时间与患者敏锐度，目的地医院和一天中的时间之间的关联。

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INTRODUCTION: The availability of ambulances to respond to emergency calls is related to their ability to return to service from the hospital. Extended hospital turnaround times decrease the number of available unit hours ambulances are deployed, which in turn can increase coverage costs or sacrifice coverage. OBJECTIVE: To determine whether ambulance turnaround times were associated with patient acuity, destination hospital, and time of day. METHODS: This retrospective analysis of ambulance hospital turnaround times utilized 12 months of data from a single, countywide, metropolitan emergency medical services (EMS) service. Turnaround time was defined as the interval between the time of ambulance arrival at the hospital and the time the ambulance became available to respond to another call. Independent variables included patient acuity (low [BLS nonemergency transport], medium [ALS care and nonemergency transport], and high [ALS care and emergency transport]), destination hospital (seven regional hospitals), and time of day (one-hour intervals). Data analysis consisted of descriptive statistics, t-tests, and linear regression. RESULTS: Of the 61,094 patient transports, the mean turnaround time was 35.6 minutes (standard deviation [SD] = 16.5). Turnaround time was significantly associated with patient acuity (p < 0.001). High-acuity calls had a mean turnaround time of 52.5 minutes (SD = 21.5), whereas moderate-acuity and low-acuity calls had mean turnaround times of 42.0 minutes (SD = 16.4) and 32.5 minutes (SD = 14.4), respectively. A statistically significant relationship between destination hospital and turnaround time was found, with the differences in means ranging from 30 seconds to 8 minutes. Similarly, time of day was associated with turnaround time, with the longest turnaround times occurring between 0600 and 1500 hours. CONCLUSION: This study demonstrated that patient acuity, destination hospital, and time of day were associated with variation in ambulance turnaround times. Research describing other system characteristics such as current emergency department census and patient handoff procedures may further demonstrate areas for improvement in HTAT. Results from this analysis may be used to inspire EMS administrators and EMS medical directors to start tracking these times to create a predictive model of EMS staffing needs.
机译：简介：救护车能否响应紧急呼叫与他们从医院恢复服务的能力有关。延长医院的周转时间会减少可部署的单位小时救护车的数量，这反过来又会增加承保范围成本或牺牲承保范围。目的：确定救护车周转时间是否与患者的敏锐度，目的地医院和一天中的时间有关。方法：这项对救护车医院周转时间的回顾性分析利用了来自单个县级大城市紧急医疗服务（EMS）服务的12个月数据。周转时间定义为救护车到达医院的时间与救护车可用于响应另一个呼叫的时间之间的间隔。自变量包括患者的敏锐度（低[BLS非紧急运输]，中等[ALS护理和非紧急运输]和高[ALS护理和紧急运输]），目的地医院（七家地区医院）和一天中的时间（一小时间隔） ）。数据分析包括描述性统计，t检验和线性回归。结果：在61,094例患者转运中，平均周转时间为35.6分钟（标准差[SD] = 16.5）。周转时间与患者的视力显着相关（p <0.001）。高敏通话的平均周转时间为52.5分钟（SD = 21.5），而中敏通话和低敏通话的平均周转时间分别为42.0分钟（SD = 16.4）和32.5分钟（SD = 14.4）。发现目的地医院与周转时间之间存在统计学上的显着关系，均值差异在30秒到8分钟之间。同样，一天中的时间与周转时间相关联，最长的周转时间发生在0600到1500小时之间。结论：这项研究表明，患者的敏锐度，目的地医院和一天中的时间与救护车周转时间的变化有关。描述其他系统特征（例如当前急诊部门普查和患者移交程序）的研究可能会进一步证明HTAT的改进领域。此分析的结果可用于激发EMS管理员和EMS医疗主管开始跟踪这些时间，从而创建EMS人员需求的预测模型。

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