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Impact of an Expeditor on Emergency Department Patient Throughput
OBJECTIVE: Our hypothesis was that an individual whose primary role was to assist with patient throughput would decrease emergency department (ED) length of stay (LOS), elopements and ambulance diversion. The objective of this study was to measure how the use of an expeditor affected these throughpu...
Autores principales: | , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Department of Emergency Medicine, University of California, Irvine School of Medicine
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099607/ https://www.ncbi.nlm.nih.gov/pubmed/21691526 |
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author | Handel, Daniel A. Ma, O. John Workman, Judi Fu, Rongwei |
author_facet | Handel, Daniel A. Ma, O. John Workman, Judi Fu, Rongwei |
author_sort | Handel, Daniel A. |
collection | PubMed |
description | OBJECTIVE: Our hypothesis was that an individual whose primary role was to assist with patient throughput would decrease emergency department (ED) length of stay (LOS), elopements and ambulance diversion. The objective of this study was to measure how the use of an expeditor affected these throughput metrics. METHODS: This pre-and post-intervention study analyzed ED patients ≥ 21-years-old between June 2008 and June 2009, at a level one trauma center in an academic medical center with an annual ED census of 40,000 patients. We created the expeditor position as our study intervention in December 2008, by modifying the job responsibilities of an existing paramedic position. An expeditor was on duty from 1PM–1AM daily. The pre-intervention period was June to November 2008, and the post-intervention period was January to June 2009. We used multivariable to assess the impact of the expeditor on throughput metrics after adjusting for confounding variables. RESULTS: We included a total of 13,680 visits in the analysis. There was a significant decrease in LOS after expeditor implementation by 0.4 hours, despite an increased average daily census (109 vs. 121, p<0.001). The expeditor had no impact on elopements. The probability that the ED experienced complete ambulance diversion during a 24-hour period decreased from 55.2% to 16.0% (OR:0.17, 95%CI:0.05–0.67). CONCLUSION: The use of an expeditor was associated with a decreased LOS and ambulance diversion. These findings suggest that EDs may be able to improve patient flow by using expeditors. This tool is under the control of the ED and does not require larger buy-in, resources, or overall hospital changes. |
format | Text |
id | pubmed-3099607 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Department of Emergency Medicine, University of California, Irvine School of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-30996072011-06-20 Impact of an Expeditor on Emergency Department Patient Throughput Handel, Daniel A. Ma, O. John Workman, Judi Fu, Rongwei West J Emerg Med ED Administration OBJECTIVE: Our hypothesis was that an individual whose primary role was to assist with patient throughput would decrease emergency department (ED) length of stay (LOS), elopements and ambulance diversion. The objective of this study was to measure how the use of an expeditor affected these throughput metrics. METHODS: This pre-and post-intervention study analyzed ED patients ≥ 21-years-old between June 2008 and June 2009, at a level one trauma center in an academic medical center with an annual ED census of 40,000 patients. We created the expeditor position as our study intervention in December 2008, by modifying the job responsibilities of an existing paramedic position. An expeditor was on duty from 1PM–1AM daily. The pre-intervention period was June to November 2008, and the post-intervention period was January to June 2009. We used multivariable to assess the impact of the expeditor on throughput metrics after adjusting for confounding variables. RESULTS: We included a total of 13,680 visits in the analysis. There was a significant decrease in LOS after expeditor implementation by 0.4 hours, despite an increased average daily census (109 vs. 121, p<0.001). The expeditor had no impact on elopements. The probability that the ED experienced complete ambulance diversion during a 24-hour period decreased from 55.2% to 16.0% (OR:0.17, 95%CI:0.05–0.67). CONCLUSION: The use of an expeditor was associated with a decreased LOS and ambulance diversion. These findings suggest that EDs may be able to improve patient flow by using expeditors. This tool is under the control of the ED and does not require larger buy-in, resources, or overall hospital changes. Department of Emergency Medicine, University of California, Irvine School of Medicine 2011-05 /pmc/articles/PMC3099607/ /pubmed/21691526 Text en Copyright © 2011 the authors. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | ED Administration Handel, Daniel A. Ma, O. John Workman, Judi Fu, Rongwei Impact of an Expeditor on Emergency Department Patient Throughput |
title | Impact of an Expeditor on Emergency Department Patient Throughput |
title_full | Impact of an Expeditor on Emergency Department Patient Throughput |
title_fullStr | Impact of an Expeditor on Emergency Department Patient Throughput |
title_full_unstemmed | Impact of an Expeditor on Emergency Department Patient Throughput |
title_short | Impact of an Expeditor on Emergency Department Patient Throughput |
title_sort | impact of an expeditor on emergency department patient throughput |
topic | ED Administration |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099607/ https://www.ncbi.nlm.nih.gov/pubmed/21691526 |
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