M Christien van der Linden1, Barbara E A M Meester2, Naomi van der Linden3. 1. Clinical Epidemiologist, Emergency Department, Medical Center Haaglanden, P.O. Box 432, 2501 CK The Hague, The Netherlands. Electronic address: c.van.der.linden@mchaaglanden.nl. 2. Emergency Nurse Practitioner, Emergency Department, Medical Center Haaglanden, P.O. Box 432, 2501 CK The Hague, The Netherlands. 3. Research Fellow, Center for Health Economics Research and Evaluation, University of Technology Sydney, P.O. Box 123 Broadway, Sydney, NSW 2007, Australia.
Abstract
INTRODUCTION: During emergency department (ED) crowding there is an imbalance between the need for emergency care and available resources. We assessed the impact of crowding on the triage process. METHODS: A 1-year health records review of 49,539 patient visits was performed. Data extracted included: occupancy ratio, ED occupancy, demographics, length of stay (LOS), time to triage, triage score, years working as a triage nurse, and triage destination. Data were analyzed using descriptive statistics and regression analyses. RESULTS: During crowding, target times to triage elapsed more often than during non-crowding (49.7% vs. 24.9%, P <0.001), and more patients were not triaged (2.2% vs. 1.6%, P <0.001). A higher ED occupancy was associated with longer waiting times for triage and longer LOS (P <0.001). There were 12,627 (25.5%) patients redirected to the general practitioner cooperative (GPC). No association between level of crowdedness and number of patients who were redirected to the GPC was found (P = 0.122). Redirection to the GPC occurred significantly more often when the triage nurse had more years working as a triage nurse (P <0.001). CONCLUSION: At this hospital, crowding affects the triage process, leading to longer waiting times to triage and longer ED LOS. Crowding did not influence triage destination.
INTRODUCTION: During emergency department (ED) crowding there is an imbalance between the need for emergency care and available resources. We assessed the impact of crowding on the triage process. METHODS: A 1-year health records review of 49,539 patient visits was performed. Data extracted included: occupancy ratio, ED occupancy, demographics, length of stay (LOS), time to triage, triage score, years working as a triage nurse, and triage destination. Data were analyzed using descriptive statistics and regression analyses. RESULTS: During crowding, target times to triage elapsed more often than during non-crowding (49.7% vs. 24.9%, P <0.001), and more patients were not triaged (2.2% vs. 1.6%, P <0.001). A higher ED occupancy was associated with longer waiting times for triage and longer LOS (P <0.001). There were 12,627 (25.5%) patients redirected to the general practitioner cooperative (GPC). No association between level of crowdedness and number of patients who were redirected to the GPC was found (P = 0.122). Redirection to the GPC occurred significantly more often when the triage nurse had more years working as a triage nurse (P <0.001). CONCLUSION: At this hospital, crowding affects the triage process, leading to longer waiting times to triage and longer ED LOS. Crowding did not influence triage destination.
Authors: Dorine M Borensztajn; Nienke N Hagedoorn; Enitan D Carrol; Ulrich von Both; Juan Emmanuel Dewez; Marieke Emonts; Michiel van der Flier; Ronald de Groot; Jethro Herberg; Benno Kohlmaier; Emma Lim; Ian K Maconochie; Federico Martinon-Torres; Daan Nieboer; Ruud G Nijman; Rianne Oostenbrink; Marko Pokorn; Irene Rivero Calle; Franc Strle; Maria Tsolia; Clementien L Vermont; Shunmay Yeung; Dace Zavadska; Werner Zenz; Michael Levin; Henriette A Moll Journal: Lancet Reg Health Eur Date: 2021-07-12
Authors: Sebastian Schnaubelt; Felix Eibensteiner; Julia Oppenauer; Andrea Kornfehl; Roman Brock; Laura Poschenreithner; Na Du; Enrico Baldi; Oliver Schlager; Alexander Niessner; Hans Domanovits; Dominik Roth; Patrick Sulzgruber Journal: J Pers Med Date: 2022-04-14
Authors: P Keessen; C H M Latour; I C D van Duijvenbode; B Visser; A Proosdij; D Reen; W J M Scholte Op Reimer Journal: BMC Cardiovasc Disord Date: 2020-11-23 Impact factor: 2.174