Learning Objective 1: describe the aim and structure of Emergency Department fast track systems
Learning Objective 2: understand the effect of Emergency Department fast-track systems on quality of care indicators
Aim: The aim of this study was to examine the effect of ED fast-track on quality of care indicators for patients with distal wrist fractures: waiting time, ED length of stay, and frequency and timing of x-ray and analgesia.
Methods: A pair-matched case-control design was used. The study intervention was ED fast-track that was implemented in November 2006. Cases were patients treated via ED fast-track and controls were patients managed via usual ED processes prior to establishment of the fast-track system. Cases were matched to controls according to age, gender, triage category and ED discharge diagnosis. Wrist fracture was the most common ED discharge diagnosis among fast-track patients and results from a subset of 133 case matched pairs with wrist fracture are presented in this paper. Data were collected using the ED Information System and medical record audit.
Results: The distribution of Australasian Triage Scale categories was: Category 3 = 1%, Category 4 = 55% and ATS Category 5 = 44%. Cases had a higher incidence of analgesia administration: (63% versus 36%, p = 0.03) however there was no significant between-group difference in median time to analgesia. Median time to x-ray was 136 minutes for cases and 100 minutes for controls (P=0.01)
Conclusion: Fast-track decreased ED length of stay for non admitted patients and may improve quality of emergency care for specific patient groups.
This study was generously funded by a Northern Health Small Research Grant
See more of: Research Sessions – Oral Paper & Posters