The impact of a fast track area on quality and effectiveness outcomes: A Middle Eastern emergency department perspective

• Main Authors: Drennan Jonathan, Van Dyke Murray, Parsons Howard, Devkaran Subashnie, Rajah Jaishen
• Format: Article
• Language: English
• Published: BMC 2009-06-01
• Series: BMC Emergency Medicine
• Online Access: http://www.biomedcentral.com/1471-227X/9/11

<p>Abstract</p> <p>Background</p> <p>Emergency department (ED) overcrowding is a ubiquitous problem with serious public health implications. The fast track area is a novel method which aims to reduce waiting time, patient dissatisfaction and morbidity. |The study objective was to determine the impact of a fast track area (FTA) on both effectiveness measures (i.e. waiting times [WT] and length of stay [LOS]) and quality measures (i.e. LWBS rates and mortality rates) in non-urgent patients. The secondary objective was to assess if a FTA negatively impacted on urgent patients entering the ED.</p> <p>Methods</p> <p>The study took place in a 500 bed, urban, tertiary care hospital in Abu Dhabi, United Arab Emirates. This was a quasi-experimental, which examined the impact of a FTA on a pre-intervention control group (January 2005) (n = 4,779) versus a post-intervention study group (January 2006) (n = 5,706).</p> <p>Results</p> <p>Mean WTs of Canadian Triage Acuity Scale (CTAS) 4 patients decreased by 22 min (95% CI 21 min to 24 min, <it>P </it>< 0.001). Similarly, mean WTs of CTAS 5 patients decreased by 28 min (95% CI 19 min to 37 min, <it>P </it>< 0.001) post FTA. The mean WTs of urgent patients (CTAS 2/3) were also significantly reduced after the FTA was opened (<it>P </it>< 0.001). The LWBS rate was reduced from 4.7% to 0.7% (95% CI 3.37 to 4.64; <it>P </it>< 0.001). Opening a FTA had no significant impact on mortality rates (<it>P </it>= 0.88).</p> <p>Conclusion</p> <p>The FTA improved ED effectiveness (WTs and LOS) and quality measures (LWBS rates) whereas mortality rate remained unchanged.</p>