Effectiveness of a Disability Liaison Officer service in a metropolitan emergency department.

Objectives: To identify the influence of a Disability Liaison Officer (DLO) service in the ED setting on people with disability (PWD). For this project, PWD included adults with communication disability, intellectual disability or autism spectrum disorder.

Methods: This was a single-centre retrospective cohort study, at an adult major referral ED in Melbourne, Australia. Patients were eligible for inclusion if they were ≥18 years of age, presented to the ED between 1 April 2022 and 30 April 2023, and had a disability alert in their electronic medical record. Eligible patients were divided into two cohorts: (i) patients managed using standard ED care and (ii) patients managed using DLO model. ED length of stay (LOS) was the main outcome measure.

Results: After adjusting for baseline differences in age, initial GCS and disability type, the DLO service was associated with earlier disposition from the ED (adjusted hazard ratio [aHR] 1.44; 95% confidence interval [CI]: 1.23-1.69; P < 0.001). For the subgroup of patients discharged directly from the ED, the association of DLO service and earlier disposition remained statistically significant (aHR 2.47; 95% CI: 1.83-3.33; P < 0.001). Among patients admitted to the emergency short stay unit (aHR 1.67; 95% CI: 0.99-2.80; P = 0.06), and those admitted to inpatient wards (aHR 0.89; 95% CI: 0.65-1.23; P = 0.50), there was no significant association of the DLO service with time to disposition.

Conclusions: The DLO service was associated with a reduction in ED LOS for PWD. Further assessment of the service using patient- and carer-reported outcome measures and cost-effectiveness studies are indicated.