None listed
Conditions
Brief summary
Emergency Department (ED) Overcrowding is associated with reduced performance in standard process and flow measures, and worse patient outcomes including mortality. Access block, the situation of patients experiencing prolonged delays in the ED whilst waiting for an inpatient bed, is a particular issue for which the solutions lie outside the ED. There have been several detailed reports on effective hospital-wide interventions in Australia, with demonstrated improvements in process and flow and some evidence of mortality benefit. However, all of the previous reports have been retrospective and thus may suffer from publication bias. The aim of this study is to prospectively document the effects of a multimodal hospital-wide intervention on ED process, flow, and outcomes. In late 2015 and early 2016, The Canberra Hospital is undertaking such an intervention. This study will examine the effects using retrospective controls, Primary outcomes will be the workload caused by excessive inpatients in ED (hours per week with more than 13 inpatients in ED) and ED flow as measured by the standard National Emergency Access Target (4 hours). Secondary outcomes will be standard hospital measures including length of stay, readmission rates, and mortality.
Interventions
Previously planned multimodal hospital wide intervention comprising:
1. Changes to admission, discharge and bed management processes to reduce the load of admitted patients waiting for inpatient beds in the Emergency Department
2. Physical rebuild of the Emergencty Department to increase available space and improve flow
3. Alteration in Emergency Department staffing, roles and administration
These changes began in late 2015 and the study period will be calendar years 2016 and 2017. Observations
Previously planned multimodal hospital wide intervention comprising: 1. Changes to admission, discharge and bed management processes to reduce the load of admitted patients waiting for inpatient beds in the Emergency Department 2. Physical rebuild of the Emergencty Department to increase available space and improve flow 3. Alteration in Emergency Department staffing, roles and administration These changes began in late 2015 and the study period will be calendar years 2016 and 2017. Observations will be gathered from hospital clinical information systems and patient notes as necessary
Sponsors
Prof Drew Richardson
Eligibility
Sex/Gender
All
Healthy volunteers
No
Inclusion criteria
All presentations to the Emergency department
Exclusion criteria
Nil
Outcome results
None listed