The National Emergency Access Target performance and all that!!

Impact of patient isolation on emergency department length of stay: A retrospective cohort study using the Registry for Emergency Care

“…The validity of 4 h as a cut-off point has also been questioned, given the risk of an adverse outcome attributable to a prolonged ED stay is likely to be proportional to the LOS (albeit in a non-linear fashion). 19,20,22 That said, 4 h is a widely used threshold and has been endorsed as an access target in multiple jurisdictions. It has also been linked to improved patient outcomes.…”

“…Nevertheless, the sample size was relatively large, and the analysis of system‐level data generated a clear answer to the research question. The validity of 4 h as a cut‐off point has also been questioned, given the risk of an adverse outcome attributable to a prolonged ED stay is likely to be proportional to the LOS (albeit in a non‐linear fashion) 19,20,22 . That said, 4 h is a widely used threshold and has been endorsed as an access target in multiple jurisdictions.…”

“…The above steps were repeated to examine the impact of isolation on ED LOS after dichotomising using a 4-h cut-off, a widely utilised emergency access target linked to better patient outcomes. 19,20 The unadjusted association between isolation and an ED LOS of greater or less than 4 h was analysed using univariable logistic regression, while multivariable logistic regression was used to determine the independent association between an ED LOS of greater or less than 4 h and isolation. Again, potential confounders were included in the regression analysis according to whether or not they had a statistically significant association with both the primary exposure variable and the primary outcome variable.…”

Review article: Pre‐hospital provider clinical judgement upon arrival to the emergency department: A systematic review and meta‐analysis

“…Such interventions are an integral part of the long-term strategy to improve access to timely and appropriate emergency care, and to reduce unnecessary time that patients spend in EDs. 2 Previous systematic reviews have focused on PHP-initiated nontransportwhere insufficient evidence to support PHP-initiated nontransport was found, 3 pre-hospital trauma triagewith similar findings 4 and ongoing research is focused towards information transfer from PHPs to hospital clinicians. 5 However, the accuracy of pre-hospital assessment to be used in prediction of clinical course in the ED have not been previously synthesised.…”

“…These include conjoint medical and nursing clinical notes and streamlined documentation. Such interventions are an integral part of the long‐term strategy to improve access to timely and appropriate emergency care, and to reduce unnecessary time that patients spend in EDs 2 …”