Abstract
Background
Prolonged emergency department (ED) length of stay (LOS) is associated with poorer
clinical outcomes and patient experience. At our community hospital, trauma patients
were experiencing extended ED LOS incommensurate with their clinical status. Our objective
was to determine if operational modifications to patient flow would reduce the LOS
for trauma patients.
Method
We conducted a retrospective chart review of admitted trauma patients from January
1, 2015 to June 30, 2016 to study two interventions. First, a communication intervention
[INT1], which required the ED provider to directly notify the trauma service, was
studied. Second, a bed intervention [INT2], which reserved two temporary beds for
trauma patients, was added. The primary outcome was the average ED LOS change across
three time periods: (1) Baseline data [BASE] collected from January 1, 2015 to June
30, 2015, (2) INT1 data collected from July 1, 2015 to October 18, 2015, and (3) INT2
data collected from October 19, 2015 to June 30, 2016. Data was analyzed using descriptive
statistics, two-sample t-tests, and multivariate linear regression.
Results
A total of 777 trauma patients were reviewed, with 151, 150 and 476 reviewed during
BASE, INT1, and INT2 time periods, respectively. BASE LOS for trauma patients was
389 min. After INT1, LOS decreased by 74.35 min (±31.92; p < 0.0001). After INT2 was
also implemented, LOS decreased by 164.56 min (±22.97; p < 0.0001) from BASE LOS.
Conclusion
Direct communication with the trauma service by the ED provider and reservation of
two temporary beds significantly decreased the LOS for trauma patients.
Keywords
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Article Info
Publication History
Published online: August 07, 2018
Accepted:
August 7,
2018
Received in revised form:
August 7,
2018
Received:
March 3,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
