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首页> 外文期刊>Emergency medicine Australasia: EMA >Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study
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Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study

机译：救护车到达患者的急诊部门转移：回顾性观察研究

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Abstract Objective Extended delays in the transfer of patients from ambulance to ED can compromise patient flow. The present study aimed to describe the relationship between the use of an Emergency Department Ambulance Off‐Load Nurse (EDAOLN) role, ED processes of care and cost effectiveness. Methods This was a retrospective observational study over three periods of before (T1), during (T2) and after (T3) the introduction of the EDAOLN role in 2012. Ambulance, ED and cost data were linked and used for analysis. Processes of care measures analysed included: time to be seen by a doctor from ED arrival (primary outcome), ambulance‐ED offload compliance, proportion of patients seen within recommended triage timeframe, ED length of stay (LoS), proportion of patients transferred, admitted or discharged from the ED within 4 h and cost effectiveness. Results A total of 6045 people made 7010 presentations to the ED by ambulance over the study period. Several measures improved significantly between T1 and T2 including offload compliance (T1: 58%; T2: 63%), time to be seen (T1: 31 min; T2: 28 min), ED LoS (T1: 335 min; T2: 306 min), ED LoS 4 h (T1: 31%; T2: 33%). Some measures carried over into T3, albeit to a lesser extent. Post‐hoc analyses showed that outcomes improved most for less urgent patients. The annualised net cost of the EDAOLN (if funded from additional resources) of $130?721 could result in an annualised reduction of approximately 3912?h in waiting time to be seen by a doctor. Conclusion With the EDAOLN role in place, slight outcome improvements in several key ambulance and ED efficiency criteria were noted. During times of ED crowding, the EDAOLN role may be one cost‐effective strategy to consider.
机译：摘要目的延长延长延长延长患者从救护车转移到ED可以危及患者流动。本研究旨在描述急诊部救护车废除护士（EDAOLN）角色，ED的护理和成本效益之间的关系。方法这是在（t1）的三个时段（t1），（t2）和（t3）之后的回顾性观测研究，在2012年引入EDAOLN作用。救护车，ED和成本数据链接并用于分析。分析的护理程序包括：由ED到达（主要结果）的医生看到的时间，救护车-ED卸载遵守情况，推荐的患者中观看的患者的比例，ED的逗留时间（LOS），转移患者的比例，在4小时内从ED中录取或排放，成本效益。结果总共6045人通过救护车对研究期间施工进行了7010人的演示。 T1和T2之间的几种措施在包括卸载顺应性（T1：58％; T2：63％）之间有显着改善（T1：58％），可以看到时间（T1：31分钟; T2：28分钟），ED LOS（T1：335分钟; T2：306 MIN），ED LOS＆LT; 4小时（T1：31％; T2：33％）。一些措施转移到T3中，尽管较小程度。后HOC分析表明，对于较少的迫切患者，结果最多改善了。 EDAOLN（如果从其他资源资助）的年化净成本为130美元？721可能导致医生等待时间约为3912？H的年度减少。结论采用EDAOLN作用，注意到几种关键救护车和ED效率标准的轻微结果改进。在ED拥挤期间，EDAOLN角色可能是需要考虑的一个具有成本效益的策略。

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  • 作者

    Crilly Julia; Johnston Amy NB; Wallis Marianne; ODwyer John; Byrnes Joshua; Scuffham Paul; Zhang Ping; Bosley Emma; Chaboyer Wendy; Green David;

  • 作者单位

    Department of Emergency MedicineGold Coast University Hospital Gold Coast HealthGold Coast;

    Department of Emergency MedicineGold Coast University Hospital Gold Coast HealthGold Coast;

    Menzies Health Institute QueenslandGriffith UniversityGold Coast Queensland Australia;

    Department of Emergency MedicineGold Coast University Hospital Gold Coast HealthGold Coast;

    Menzies Health Institute QueenslandGriffith UniversityGold Coast Queensland Australia;

    Menzies Health Institute QueenslandGriffith UniversityGold Coast Queensland Australia;

    Menzies Health Institute QueenslandGriffith UniversityGold Coast Queensland Australia;

    Office of the Commissioner Queensland Ambulance Service Department of HealthBrisbane Queensland;

    Menzies Health Institute QueenslandGriffith UniversityGold Coast Queensland Australia;

    Department of Emergency MedicineGold Coast University Hospital Gold Coast HealthGold Coast;

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  • 正文语种 eng
  • 中图分类 外科学;
  • 关键词

    advanced practice nurse; ambulance; emergency department; evaluation; patient outcomes;

    机译：高级练习护士;救护车;急诊部;评估;患者结果;

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