Number of Consults and Response Times to ED: Effects on Patient Flow and Outcomes.

Q4 Medicine Connecticut Medicine Pub Date : 2017-02-01

Mario F Perez, Jurgen L Holleck, Michael Sfondrini, Edward Nemergut, Craig G Gunderson, Daniel G Federman

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Abstract

Objectives: 'he number of consults and response times to our Emergency Department (ED) were tracked to understand the effects on patient flow and outcomes.

Study design: We conducted a prospective observational study using convenience samples.

Methods: There were 992 requests for physician consultations or logistical services (bed manager, transport, or room cleaning) logged during ED shifts from January through July, 2014 at the VA CT Healthcare System West Haven Campus (VACHS). Services were paged every 15 minutes until a response was received; the total response time was then recorded. One-hundred-eighty-six requests were triggered by one author's cohort of 392 patients, for which age, disposition, and outcomes were also tracked.

Results: The median response times were one to six minutes depending on the service requested; outli- ers exceeded an hour. A patient's ED stay duration increased with the number of services paged. The number of services paged was associated with mortality despite adjusting for age, ED waiting time, ED total time, and disposition (odds ratio = 3.14, P = .02) although comorbidity scores were not tracked.

Conclusions: Response time to ED pages varies widely. The number of services paged correlated with ED length of stay and possibly inpatient mortality.

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会诊人数和ED反应时间:对患者流量和结果的影响。

目的:追踪急诊部(ED)的会诊次数和响应时间，以了解对患者流量和结果的影响。研究设计:我们采用方便样本进行前瞻性观察研究。方法:2014年1月至7月，VA CT医疗保健系统西黑文校区(VACHS)急诊科轮班期间记录的992例医生咨询或后勤服务(床位管理、运输或房间清洁)请求。在收到响应之前，每15分钟对服务进行一次分页;然后记录总响应时间。一位作者的392名患者队列触发了186项请求，这些患者的年龄、性格和结果也被跟踪。结果:响应时间中位数为1至6分钟，具体取决于所请求的服务;时间超过了一个小时。病人在急诊室的停留时间随着服务页数的增加而增加。尽管没有跟踪共病评分，但尽管调整了年龄、急诊科等待时间、急诊科总时间和处置(优势比= 3.14,P = 0.02)，但服务页的数量与死亡率相关。结论:对ED页面的响应时间差异很大。服务页面的数量与急诊科的住院时间和可能的住院死亡率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Connecticut Medicine Medicine-Medicine (all)

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期刊介绍： The Connecticut State Medical Society (CSMS) is a federation of eight component county medical associations, with a total membership exceeding 7,000 physicians. CSMS itself is a constituent state entity of the American Medical Association. Founded by the physician-patriots of the American Revolution, the Society operates from a heritage of democratic principles embodied in its Charter and Bylaws. The base of all authority in CSMS is, of course, the individual physician member. It is the decisions of members in their own county associations that ultimately determine the nature of the Society"s policies and activities.

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