+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Impact of opening a new emergency department on healthcare service and patient outcomes: analyses based on linking ambulance, emergency and hospital databases



Impact of opening a new emergency department on healthcare service and patient outcomes: analyses based on linking ambulance, emergency and hospital databases



Internal Medicine Journal 43(12): 1293-1303



Emergency department (ED) crowding caused by access block is an increasing public health issue and has been associated with impaired healthcare delivery, negative patient outcomes and increased staff workload. To investigate the impact of opening a new ED on patient and healthcare service outcomes. A 24-month time series analysis was employed using deterministically linked data from the ambulance service and three ED and hospital admission databases in Queensland, Australia. Total volume of ED presentations increased 18%, while local population growth increased by 3%. Healthcare service and patient outcomes at the two pre-existing hospitals did not improve. These outcomes included ambulance offload time: (Hospital A PRE: 10 min, POST: 10 min, P < 0.001; Hospital B PRE: 10 min, POST: 15 min, P < 0.001); ED length of stay: (Hospital A PRE: 242 min, POST: 246 min, P < 0.001; Hospital B PRE: 182 min, POST: 210 min, P < 0.001); and access block: (Hospital A PRE: 41%, POST: 46%, P < 0.001; Hospital B PRE: 23%, POST: 40%, P < 0.001). Time series modelling indicated that the effect was worst at the hospital furthest away from the new ED. An additional ED within the region saw an increase in the total volume of presentations at a rate far greater than local population growth, suggesting it either provided an unmet need or a shifting of activity from one sector to another. Future studies should examine patient decision making regarding reasons for presenting to a new or pre-existing ED. There is an inherent need to take a 'whole of health service area' approach to solve crowding issues.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 053721046

Download citation: RISBibTeXText

PMID: 23734944

DOI: 10.1111/imj.12202


Related references

The impact of opening a new emergency department on health care service and patient outcomes Analyses based on linking Ambulance, Emergency and Hospital databases. 2013

Linking ambulance, emergency department and hospital admission records to examine patient and health service delivery outcomes when opening an additional emergency department: A before and after study. Australasian Emergency Nursing Journal 12(4): 176-177, 2009

Linking ambulance, emergency department and hospital admissions data: understanding the emergency journey. Medical Journal of Australia 194(4): S34-S37, 2011

Outcomes for patients who contact the emergency ambulance service and are not transported to the Emergency Department: a data linkage study. Prehospital Emergency Care 2018: 1-27, 2018

Characteristics of Pediatric Patient Transferred From Hospital-Based General Emergency Departments to Acute-Care Facilities: An Analysis of the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. Pediatric Emergency Care 2018, 2018

Emergency Department overcrowding and ambulance diversion: the impact and potential solutions of extended boarding of admitted patients in the Emergency Department. Journal of Emergency Medicine 30(3): 351-356, 2006

Impact of discontinuing a hospital-based air ambulance service on trauma patient outcomes. Journal of Trauma 52(3): 486-491, 2002

The impact of a temporary medical ward closure on emergency department and hospital service delivery outcomes. Quality Management in Health Care 20(4): 322-333, 2012

Use of the emergency ambulance service to an inner city accident and emergency department--a comparison of general practitioner and '999' calls. Journal of the Royal Society of Medicine 84(12): 726-727, 1991

The emergency to home project: impact of an emergency department care coordinator on hospital admission and emergency department utilization among seniors. International Journal of Emergency Medicine 7: 18, 2014

Fundus Photography vs. Ophthalmoscopy Outcomes in the Emergency Department (FOTO-ED) Phase III: Web-based, In-service Training of Emergency Providers. Neuro-Ophthalmology 42(5): 269-274, 2018

The Impact of Emergency Physician Seniority on Clinical Efficiency, Emergency Department Resource Use, Patient Outcomes, and Disposition Accuracy. Medicine 95(6): E2706, 2016

Outcomes and emergency medical services resource utilization among patients with syncope arriving to the emergency department by ambulance. Cjem 2018: 1-6, 2018

The Jam In The Sandwich, Down Here In A&E': Staff Perspectives On The Impact And Causes Of Handover Delays Between The Ambulance Service And The Emergency Department. Emergency Medicine Journal 32(6): e16.3-e17, 2015

Collegiate-based emergency medical service: impact on alcohol-related emergency department transports at a small liberal arts college. Journal of American College Health 60(3): 263-265, 2012