Using emergency physicians' abilities to predict patient admission to decrease admission delay time

Emergency Medicine Journal : EMJ
Erica E M LeeChristian Vaillancourt

Abstract

In many EDs, emergency physicians (EPs) do not have admitting privileges and must wait for consultants to further assess and admit patients. This delays bed requests and increases ED crowding. We measured EPs' abilities to predict patient admission prior to consultation and estimated the potential ED stretcher time saved if EPs requested a bed with consultation. We conducted a prospective cohort study in an academic centre in Canada between October 2017 and February 2018 using a convenience sample of ED patient encounters requiring consultation. We excluded patients under 18 years or those clearly likely to be admitted (traumas, strokes, S-T elevation myocardial infarctions and Canadian Triage and Acuity Scale of 1). EPs predicted patient admission just before consultation. Potential ED stretcher time saved was estimated for correctly predicted admissions assuming bed requests were initiated with consultation and a constant time to inpatient bed. Characteristics of 454 patients were: mean age 60.1 years, 48.5% male, 46.9% evening presentation, 69.4% admitted and median time to bed request of 3.5 hours (IQR 2.0-5.3 hours). Overall, EPs prediction sensitivity, specificity, positive predictive value and negative predictive value w...Continue Reading

References

Feb 8, 2003·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Alan J ForsterCarl van Walraven
Jul 29, 2003·Annals of Emergency Medicine·Brent R AsplinCarlos A Camargo
Oct 20, 2006·Annals of Emergency Medicine·Michael J SchullJohn-Paul Szalai
Nov 2, 2007·Australian Health Review : a Publication of the Australian Hospital Association·Andrew W DentNicola E Oettel
Feb 10, 2010·Quality & Safety in Health Care·Ruben AmarasinghamW G Reed
Apr 19, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Amy M DouglassLarry J Baraff
Jan 29, 2013·Emergency Medicine Journal : EMJ·Craig BrickBrian H Rowe
Nov 2, 2013·CJEM·Andrew AffleckHoward J Ovens
May 31, 2014·Annals of Emergency Medicine·Hyojung KangChristopher J DeFlitch
Jun 10, 2014·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Michael J DrescherDavid A Pepper
Aug 13, 2014·Australasian Emergency Nursing Journal : AENJ·Milan R VaghasiyaAmith Shetty
Jul 27, 2015·Australian Health Review : a Publication of the Australian Hospital Association·Andrew BackayBiswadev Mitra
Nov 29, 2016·Journal of Clinical and Diagnostic Research : JCDR·Mohamad Adam Bujang, Tassha Hilda Adnan
Jul 2, 2018·The American Journal of Emergency Medicine·Zlata K VlodaverMichael D Zwank

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