Journal article
Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study
Emergency Medicine Australasia, Vol.32(2), pp.271-280
2020
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 $130721 could result in an annualised reduction of approximately 3912h 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.
Details
- Title
- Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study
- Authors
- Julia Crilly (Author) - Griffith UniversityAmy N B Johnston (Author) - Griffith UniversityMarianne Wallis (Author) - University of the Sunshine CoastJohn O'Dwyer (Author) - Griffith UniversityJoshua Byrnes (Author) - Griffith UniversityPaul Scuffham (Author) - Griffith UniversityPing Zhang (Author) - Griffith UniversityEmma Bosley (Author) - Queensland Ambulance ServiceWendy Chaboyer (Author) - Griffith UniversityDavid Green (Author) - Griffith University
- Publication details
- Emergency Medicine Australasia, Vol.32(2), pp.271-280
- Publisher
- Wiley-Blackwell Publishing Asia
- Date published
- 2020
- DOI
- 10.1111/1742-6723.13407
- ISSN
- 1742-6731
- Copyright note
- Copyright © 2019 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99450954602621
- Output Type
- Journal article
Metrics
25 File views/ downloads
92 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Domestic collaboration
- Web Of Science research areas
- Emergency Medicine
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites