Effect of a Multi-Diagnosis Observation Unit on Emergency Department Length of Stay and Inpatient Admission Rate at Two Canadian Hospitals

2016 ◽  
Vol 51 (6) ◽  
pp. 739-747.e3 ◽  
Author(s):  
Amy H.Y. Cheng ◽  
Neil G. Barclay ◽  
Riyad B. Abu-Laban
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Admission Rate ◽  
Inpatient Admission ◽  
Observation Unit

scholarly journals Impact of a specialist service in the Emergency Department on admission, length of stay and readmission of patients presenting with falls, syncope and dizziness

QJM ◽  
2020 ◽  
Author(s):  
K Jusmanova ◽  
C Rice ◽  
R Bourke ◽  
A Lavan ◽  
C G McMahon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Admission Rate ◽  
Readmission Rates ◽  
Specialist Service ◽  
Admission Rates ◽  
Potential Benefits ◽  
Bed Days ◽  
The Mean ◽  
The Impact

Summary Background Up to half of patients presenting with falls, syncope or dizziness are admitted to hospital. Many are discharged without a clear diagnosis for their index episode, however, and therefore a relatively high risk of readmission. Aim To examine the impact of ED-FASS (Emergency Department Falls and Syncope Service) a dedicated specialist service embedded within an ED, seeing patients of all ages with falls, syncope and dizziness. Design Pre- and post-cohort study. Methods Admission rates, length of stay (LOS) and readmission at 3 months were examined for all patients presenting with a fall, syncope or dizziness from April to July 2018 (pre-ED-FASS) inclusive and compared to April to July 2019 inclusive (post-ED-FASS). Results There was a significantly lower admission rate for patients presenting in 2019 compared to 2018 [27% (453/1676) vs. 34% (548/1620); X2 = 18.0; P < 0.001], with a 20% reduction in admissions. The mean LOS for patients admitted in 2018 was 20.7 [95% confidence interval (CI) 17.4–24.0] days compared to 18.2 (95% CI 14.6–21.9) days in 2019 (t = 0.98; P = 0.3294). This accounts for 11 344 bed days in the 2018 study period, and 8299 bed days used after ED-FASS. There was also a significant reduction in readmission rates within 3 months of index presentation, from 21% (109/1620) to 16% (68/1676) (X2 = 4.68; P = 0.030). Conclusion This study highlights the significant potential benefits of embedding dedicated multidisciplinary services at the hospital front door in terms of early specialist assessment and directing appropriate patients to effective ambulatory care pathways.

The Efficacy of Emergency Medicine Ward for the Management of Patients with Mental Disorders

2009 ◽  
Vol 16 (4) ◽  
pp. 217-223 ◽  
Author(s):  
CM Chan ◽  
MY Wong ◽  
SL Chan ◽  
MY Wan ◽  
YF Mo
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Mental Disorders ◽  
Length Of Stay ◽  
Admission Rate ◽  
Medical Ward ◽  
Attendance Rate ◽  
Number Of Patients ◽  
The Mean ◽  
Emergency Medicine Ward

Objective Patients with mental disorders are one of the target groups selected for management in the Emergency Medicine Ward (EMW) with the enrolment of psychiatric advanced practice nurses. This study aimed to determine whether the EMW can be efficiently used for the management of patients with mental disorders in terms of length of stay (LOS), admission rate, and re-attendance rate when compared with the medical ward. Methods This was a retrospective descriptive study. Patients with mental disorders were defined and recruited from the Princess Margaret Hospital during two selected study periods: pre-opening (pre-EMW) and post-opening (post-EMW) of the EMW. All emergency department records of patients with mental disorders within these two periods were reviewed and data of the selected samples were retrieved from different computer databases. Results The total number of patients with mental disorders was 565 in the pre-EMW period and 404 in the post-EMW period; 214 (37.9%) cases were admitted into the medical ward in the pre-EMW period while only 62 (15.3%) were admitted into the medical ward in the post-EMW period. The mean LOS in the pre-EMW period was 67.7 hours. For the post-EMW period, the mean LOS was 32.3 hours. The reduction in mean LOS was 35.4 hours, and 82% of the study patients treated in the EMW were discharged within 48 hours. Notably, 23.3% of the cases re-attended the emergency department after discharge from the medical ward, whereas only 8.8% of cases re-attended after discharge from the EMW. Conclusion Patients with mental disorders or related problems can be efficaciously managed in the EMW, as evidenced by a decrease in the length of stay, admission rate, and re-attendance rate.

Emergency Department Diuretic Dosing in Acute Decompensated Heart Failure and Its Effect on Length of Stay and Re-Admission Rate

2011 ◽  
Vol 17 (8) ◽  
pp. S92
Author(s):  
Jacqueline Fearon-Clarke ◽  
Simarta Brennan ◽  
Rami Bustami ◽  
Betty Merveil-Ceneus ◽  
Bernardo Vargas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Length Of Stay ◽  
Acute Decompensated Heart Failure ◽  
Admission Rate ◽  
Decompensated Heart Failure

scholarly journals Comparison of OPD-Referral and Self-Referral Patients In The Emergency Department

2021 ◽  
Author(s):  
Yu-Rung Chou ◽  
Mi-Chia Ma ◽  
Ching-Chi Lee ◽  
Chih-Chia Hsieh ◽  
Chih-Hao Lin
Keyword(s):  
Emergency Department ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Pediatric Patients ◽  
Admission Rate ◽  
Tertiary Teaching ◽  
Significant Difference ◽  
Tertiary Teaching Hospital ◽  
Referral Status ◽  
Hospital Cardiac Arrest

Abstract Background: To compare outpatient department (OPD) referral patients and self-referral patients in the emergency department (ED) in terms of hospitalization, mortality, and length of stay.Methods: We collected ED patients of a tertiary teaching hospital over a 3-month period. We excluded pediatric patients and patients with certain inconsistent characteristics, such as trauma and out-of-hospital cardiac arrest, or referral from other facilities. After propensity score matching, we compared the hospitalization, mortality, and length of stay in the ED of the OPD-referral patents and self-referral patients. We categorized the patients as “emergency” or “urgency” according to their triage information and then analyzed the effects of different severity levels.Results: The OPD-referral ED patients, compared with the self-referral patients, had a higher admission rate (49.8% vs. 28.9%, p < 0.001; odds ratio [OR] = 2.44, 95% confidence intervals [CIs]: 1.91 - 3.12). Among the emergency patients, there was no significant difference regarding the admission rate (62.6% vs. 55.8%, p = 0.257) or the mortality rate (4.6% vs. 8%, p = 0.253). Among the urgent patients, the admission rate was significantly different between the OPD-referral and self-referral groups (46% vs. 20.2%, p < 0.001; OR = 3.36, 95% CIs: 2.48 - 4.55). The urgent patients who were referred from OPD tended to have a higher mortality rate (2.1% vs. 0.5%, p = 0.064). Regarding the length of ED stay, only the discharge and urgent subgroups differed according to OPD- and self-referral status (p < 0.001), with a median of 5.8 hours versus 2.3 hours.Conclusions: The OPD-referral ED patients have a higher admission rate and a longer length of stay than self-referral patients in urgent triage. The OPD-referral ED patients might have more severe and complex conditions. We should be more alert to OPD-referred patients even when they initially appear not severely ill.

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