Predictive factors for longer length of stay in an emergency department: a prospective multicentre study evaluating the impact of age, patient's clinical acuity and complexity, and care pathways

Casalino, Enrique; Wargon, Mathias; Peroziello, Anne; Choquet, Christophe; Leroy, C.; Beaune, Sébastien; Pereira, Laurent; Bernard, Julien; Buzzi, Jean‐Claude

doi:10.1136/emermed-2012-202155

Cited by 74 publications

(72 citation statements)

References 26 publications

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“…Finally, patients being transferred to a hospital ward may be less likely to have their treatment completed in the AAU. Although, in the literature, consultations15 and specialist advice17 have been associated with longer LOS, our findings suggest that this was not the case for the CP intervention in our study.…”

Section: Discussioncontrasting

confidence: 65%

Impact of clinical pharmacist intervention on length of stay in an acute admission unit: a cluster randomised study

et al. 2015

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Objectives Physicians in acute admission units (AAUs) are obliged to obtain medication history and perform medication reconciliation, which is time consuming and often incomplete. Studies show that clinical pharmacists (CPs) can obtain accurate medication histories, but so far no studies have investigated the effect of this on time measures. Therefore, the objective of the present study was to investigate the effect of a CP intervention on length of stay (LOS) in an AAU. Methods The study was designed as a prospective, cluster randomised study. Weekdays were randomised to control or intervention. CP intervention consisted of obtaining medication history and performing medication reconciliation and review. The primary outcome was LOS in the AAU. Secondary outcomes were other timerelated measures-for example, physicians' self-reported time spent on medication topics. Finally, the number of documented medications per patient was established. Results 232 and 216 patients, respectively, were included on control (n=63) and intervention (n=63) days. The mean LOS was 342 (95% CI 323 to 362) min in the intervention group and 339 (95% CI 322 to 357) min in the control group, which was not statistically significantly different. Physicians spent on average 4.3 (95% CI 3.7 to 5.0) min in the intervention group and 7.5 (95% CI 6.6 to 8.5) min in the control group, corresponding to an overall reduction of 43.0% (95% CI 30.9% to 53.

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Section: Discussioncontrasting

confidence: 65%

Impact of clinical pharmacist intervention on length of stay in an acute admission unit: a cluster randomised study

et al. 2015

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“…Acuity tends to show a bell-shaped relationship with LOS: in five of nine studies, LOS was shortest for patients with the highest acuity (short waits) or lowest acuity (short treatment and/or fast-tracking), and longest for those in the middle (ie, three on the Canadian Triage Acuity Scale (CTAS)) 6 14 17 22 394 10 or at higher acuity levels in general,11 and one found a linear negative relationship between acuity and LOS 26. In four of six condition-specific studies, one or more indicators of severity predicted longer stay 12 13 25 38…”

Section: Resultsmentioning

confidence: 99%

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Need for admission . Not surprisingly, admitted patients stay much longer than non-admitted ones (10 of 10 studies) 4 6 11 12 15 21 22 27 34 38

Severity and acuity of condition .

…”

Section: Resultsmentioning

confidence: 99%

Patient characteristics associated with longer emergency department stay: a rapid review

et al. 2015

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“…It is hypothesised that the ability to observe the overall ED status with highlighted alerts and exceptions can decrease LOS. LOS is commonly measured by EDs as an indicator for effectiveness and efficiency, and used as a proxy for good service (Casalino et al, 2014). Thus, the prototype evaluation will focus on examining the following research question:…”

Section: Introductionmentioning

confidence: 99%

Simulating the impact of an online digital dashboard in emergency departments on patients length of stay

Mazor

Heart

Even

2016

Journal of Decision Systems

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a Department of industrial engineering and management, Ben-Gurion university of the negev, Beer-sheva, israel; b faculty of Business administration, ono academic college, Kiriat-ono, israel ABSTRACTOvercrowding at EDs is a world known problem which negatively affects the quality of medical care. It is evident, for example, by long patients' waiting times. EDs frequently use average patients' length of stay (LOS) as a performance indicator. Long LOS is commonly correlated with overcrowding. In this research, a prototype of an electronic online digital dashboard, termed operational BI, was developed following the Design Science Research methodology. The system is targeted to be used by the ED staff. Simulation was used to assess if such a system, which displays ED's critical data in a dashboard visualisation, can decrease LOS, thereby ease EDs' overcrowding. Six scenarios were simulated, depicting various use patterns. The results show a potential decrease of 34-44% in average LOS, depending on the use pattern. These are promising results that call for further, realworld examination of the system.

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Predictive factors for longer length of stay in an emergency department: a prospective multicentre study evaluating the impact of age, patient's clinical acuity and complexity, and care pathways

Cited by 74 publications

References 26 publications

Impact of clinical pharmacist intervention on length of stay in an acute admission unit: a cluster randomised study

Impact of clinical pharmacist intervention on length of stay in an acute admission unit: a cluster randomised study

Patient characteristics associated with longer emergency department stay: a rapid review

Simulating the impact of an online digital dashboard in emergency departments on patients length of stay

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