Elisabeth S J van Gils-van Rooij1,2, Berthold R Meijboom1, Sjoerd M Broekman3, Christoffel J Yzermans3, Dingenus H de Bakker1,3. 1. Scientific Center for Transformation in Care and Welfare (Tranzo), Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg. 2. Out-of-hours General Practitioner service Oost-Brabant, 's-Hertogenbosch. 3. The Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
Abstract
OBJECTIVE: Emergency Departments and out-of-hours General Practitioner services collaborate increasingly in Urgent Care Collaborations (UCCs) by sharing one combined entrance and joint triage. The aim of this study is to examine the difference between UCCs and providers who operate separately with respect to the efficiency of patient flow. METHODS: This study had a cross-sectional observational design comparing three regions with UCC with three regions with usual care. Outcome measures were efficiency of patient flow, defined as a reducing length of stay (LOS), waiting time (WT) and the mean number of handovers. Data were obtained from electronic medical records. RESULTS: LOS (median 34:00 vs. 38:52 min) and WT (median 14:00 vs. 18:43 min) were statistically significantly longer in UCCs compared with usual care. This difference is mainly explained by the prolonged LOS and WT for consulting a General Practitioner. The mean number of interunit handovers was larger in UCCs. CONCLUSION: The results indicate that, on average, UCCs do not enhance the efficiency of patient flow. The median LOS and WT are longer in UCCs and more handovers occur in UCCs compared with usual care.
OBJECTIVE: Emergency Departments and out-of-hours General Practitioner services collaborate increasingly in Urgent Care Collaborations (UCCs) by sharing one combined entrance and joint triage. The aim of this study is to examine the difference between UCCs and providers who operate separately with respect to the efficiency of patient flow. METHODS: This study had a cross-sectional observational design comparing three regions with UCC with three regions with usual care. Outcome measures were efficiency of patient flow, defined as a reducing length of stay (LOS), waiting time (WT) and the mean number of handovers. Data were obtained from electronic medical records. RESULTS: LOS (median 34:00 vs. 38:52 min) and WT (median 14:00 vs. 18:43 min) were statistically significantly longer in UCCs compared with usual care. This difference is mainly explained by the prolonged LOS and WT for consulting a General Practitioner. The mean number of interunit handovers was larger in UCCs. CONCLUSION: The results indicate that, on average, UCCs do not enhance the efficiency of patient flow. The median LOS and WT are longer in UCCs and more handovers occur in UCCs compared with usual care.
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Authors: Maya M Jeyaraman; Rachel N Alder; Leslie Copstein; Nameer Al-Yousif; Roger Suss; Ryan Zarychanski; Malcolm B Doupe; Simon Berthelot; Jean Mireault; Patrick Tardif; Nicole Askin; Tamara Buchel; Rasheda Rabbani; Thomas Beaudry; Melissa Hartwell; Carolyn Shimmin; Jeanette Edwards; Gayle Halas; William Sevcik; Andrea C Tricco; Alecs Chochinov; Brian H Rowe; Ahmed M Abou-Setta Journal: BMJ Open Date: 2022-04-20 Impact factor: 3.006