IntroductionEmergency department ergonomics is an under researched topic. To our knowledge, this is the only study investigating the effectiveness of a patient self-assessment form in managing patient flow through an emergency department in a busy teaching hospital.MethodsSelf-reported information contained on the forms included patient demographics, presenting complaint, past medical, surgical and drug history, and the option to consent for the emergency care summary, which provides an up-to-date drug history from the general practitioner. This form followed the patient through the department and was utilised by the triage nurse and care providers. 200 patients in Manchester triage categories three to five were recruited, half of whom were given self-assessment forms. Time spent in triage, time taken for first assessment and total time in the department were recorded for all patients.ResultsPatients without a self-assessment form had a mean time spent in triage of 6.0± 3.6 SD min and mean time taken for first assessment of 11.0±6.0 SD min. Patients managed with a self-assessment form had a mean time spent in triage of 4.9 ±3.5 SD min and mean time taken for first assessment of 9.0±5.0 SD min. Patients without a self-assessment form had a median total time spent in the department of 201 min (range 33–301), whereas patients managed with the self-assessment form had a median time of 121 min (range 19–240). The differences in triage, first assessment and total department times between groups were significant (p<0.05).ConclusionThis pilot study showed the effectiveness of a self-assessment form at increasing patient flow through the department, reducing triage, first assessment and total department times. The reasons for this are complex and merit further investigation.
Mathematical modelling of patient flow through an accident and emergency department
