Fast track in the emergency department: A one-year experience with nurse practitioners

Wright, Seth W.; Erwin, T; Blanton, Donald; Covington, C

doi:10.1016/0736-4679(92)90345-t

Cited by 37 publications

(18 citation statements)

References 10 publications

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“…The application of a fast-tracking system (bypass the emergency department) may result in the improvement of reperfusion therapy [21,22], and probably the use of single or double dose instead of infusion thrombolytic therapy may improve care. Great effort is needed to increase use of thrombolytic therapy and to minimize the door-needle time.…”

Section: Discussionmentioning

confidence: 99%

Thrombolytic therapy use for acute myocardial infarction and outcome in Qatar

Hadi

Suwaidi

Bener

et al. 2005

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Thrombolytic therapy use for acute myocardial infarction and outcome in Qatar

Hadi

Suwaidi

Bener

et al. 2005

International Journal of Cardiology

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“…In response, many EDs have established on-site alternative locations to facilitate care of these nonacute cases, thus increasing capacity in the general ED for more acute or complicated patients. [3][4][5] These units are often staffed by experienced practitioners, who manage a large volume of patients rapidly. 6 As such, they are commonly known as ''fast tracks'' (FTs) or ''urgent care'' units.…”

Section: Any Urban Pediatric Eds Provide Carementioning

confidence: 99%

Fast Track and the Pediatric Emergency Department: Resource Utilization and Patient Outcomes

Hampers

Cha

Gutglass

et al. 1999

Academic Emergency Medicine

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Abstract. Objective: To examine differences in the evaluation, management, and outcomes for patients seen in an on-site ''fast track'' (FT) vs the main ED. Methods: Over a three-month period, patients presenting to an urban pediatric ED were prospectively assessed. Patients included were: triaged as ''nonurgent''; aged 2 months to 10 years; not chronically ill; and had fever, or complaint of vomiting, diarrhea, or decreased oral intake. Evening and weekend care was provided in the FT; at all other times these low-acuity patients were seen in the ED. Seven days after the visit, families were interviewed by telephone. Results: Four hundred seventy-nine and 557 patients were seen in the FT and ED, respectively. The patients in the two settings did not differ in age, clinical condition, race, or commercial insurance status. Patient mean test charges were $27 and $52 for the FT and ED, respectively (p < 0.01). Twenty-four percent of the FT patients vs 41% of the ED patients had tests performed (p < 0.01). Average length of stay was 28 minutes shorter in the FT (95% CI = 19 to 36, p < 0.01). Follow-up was completed for 480 of 755 families with telephones (64%). The FT and ED patients did not differ at follow-up: 90% vs 88% had improved conditions (p = 0.53), 18% vs 15% had received unscheduled follow-up care (p = 0.44), and 94% of the families in both groups were satisfied with the visit (p = 0.98). Conclusions: Compared with those in the main ED, the study patients seen in the FT had fewer tests ordered and had briefer lengths of stay. These findings were not explained by differences in patient ages, vital signs, or demographic characteristics. No difference in final outcomes or satisfaction was detected among the families contacted for follow-up. Key words: fast track; resource utilization; outcomes; urgent care. ACADEMIC EMERGENCY MEDICINE 1999; 6:1153-1159 M ANY URBAN pediatric EDs provide care for a large number of nonemergent, ambulatory patients, particularly during the winter season.1,2 Assessment and management of these children may strain resources and increase waiting times for all patients. In response, many EDs have established on-site alternative locations to facilitate care of these nonacute cases, thus increasing capacity in the general ED for more acute or complicated patients.3-5 These units are often staffed by experienced practitioners, who manage a large volume of patients rapidly.6 As such, they are commonly known as ''fast tracks'' (FTs) or ''urgent care'' units. Fast tracks have been shown to decrease waiting times, and are generally regarded as a more efficient alternative to the main ED for care of uncomplicated patients with low-acuity concerns. 7,8 What has not been well-studied, however, are the differences in care provided in these settings. Specifically, it is unclear whether such patients are investigated and managed differently than they would have been in the main ED, and more important, whether such differences affect patient outcomes.We undertook this study to determine whether the...

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“…Civilian hospitals have developed various strategies to address patients with minor complaints varying from outright refusal of care, to triaging to off-site clinics, developing nonurgent care clinics and establishing Fast Track Clinics also known as Minor Emergency Areas (MEAs) within existing emergency departments. These Fast Track clinics have been staffed with a variety of non-physician, midlevel health care providers including nurse practitioners (Covington, Erwin & Sellers, 1991;Grumbeck et al, 1993;Simon et al, 1996;Wright, Erwin, Blanton & Covington, 1992).…”

Section: Introductionmentioning

confidence: 99%

Perceptions of Emergency Department Physicians Toward Collaborative Practice With Nurse Practitioners in an Emergency Department Setting

Wingert¹

1998

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As the role of the family nurse practitioner within the United States Air Force continues to be defined, one setting where a need for additional primary care providers exists is the Emergency Department. Nurse practitioners utilized in this setting could augment physician staffing, or could be utilized in non-urgent, Fast-Track areas within Air Force emergency departments. One essential element for role development in this area is approval and appreciation of the role of the nurse practitioner by Air Force Emergency Department physicians. This study explored Emergency Department physician's attitudes toward collaborative health care with nurse practitioners using exploratory, descriptive, qualitative methodology. Utilizing a semi-structured guide adapted from a similar 1996 study, five board-certified emergency department physicians assigned to a Level II emergency department, were interviewed. The physicians were encouraged to elaborate on their definition of nurse practitioners, to discuss their knowledge of the educational requirements, and to describe their view of the scope of practice and limitations of these advanced practice nurses. Munhall and Boyd's methods of data analysis which included theme categorization were utilized in this study. Four major themes categories emerged. The theme categories were separated into those

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Fast track in the emergency department: A one-year experience with nurse practitioners

Cited by 37 publications

References 10 publications

Thrombolytic therapy use for acute myocardial infarction and outcome in Qatar

Thrombolytic therapy use for acute myocardial infarction and outcome in Qatar

Fast Track and the Pediatric Emergency Department: Resource Utilization and Patient Outcomes

Perceptions of Emergency Department Physicians Toward Collaborative Practice With Nurse Practitioners in an Emergency Department Setting

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