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Improved outcomes for emergency department patients whose ambulance off-stretcher time is not delayed
Published (Version of record)CC BY-NC V4.0, Open
Journal article
Improved outcomes for emergency department patients whose ambulance off-stretcher time is not delayed
Emergency Medicine Australasia, Vol.27(3), pp.216-224
06/2015
PMCID: PMC4676924
PMID: 25940975
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Source: InCites
Abstract
Objective: To describe and compare characteristics and outcomes of patients who arrive by ambulance to the ED. We aimed to (i) compare patients with a delayed ambulance offload time (AOT) >30 min with those who were not delayed; and (ii) identify predictors of an ED length of stay (LOS) of >4 h for ambulance arriving patients.
Methods: A retrospective, multi-site cohort study was undertaken in Australia using 12 months of linked health data (September 2007–2008). Outcomes of AOT delayed and nondelayed presentations were compared. Logistic regression analysis was undertaken to identify predictors of an ED LOS of >4 h.
Results: Of the 40 783 linked, analysable ambulance presentations, AOT delay of >30 min was experienced by 15%, and 63% had an ED LOS of >4 h. Patients with an AOT <30 min had better outcomes for: time to triage; ambulance time at hospital; time to see healthcare professional; proportion seen within recommended triage time frame; and ED LOS for both admitted and nonadmitted patients. In-hospital mortality did not differ. Strong predictors of an ED LOS >4 h included: hospital admission, older age, triage category, and offload delay >30 min.
Conclusion: Patients arriving to the ED via ambulance and offloaded within 30 min experience better outcomes than those delayed. Given that offload delay is a modifiable predictor of an ED LOS of >4 h, targeted improvements in the ED arrival process for ambulance patients might be useful.
Details
- Title
- Improved outcomes for emergency department patients whose ambulance off-stretcher time is not delayed
- Creators
- Julia Crilly - Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, AustraliaGerben Keijzers - School of Medicine, Griffith University and Bond University, Gold Coast, Queensland, AustraliaVivienne Tippett - School of Clinical Science, Queensland University of Technology, Brisbane, Queensland, AustraliaJohn O'Dwyer - Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, AustraliaJames Lind - Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, AustraliaNerolie Bost - Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, AustraliaMarilla O'Dwyer - Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, AustraliaSue Shiels - Department of Emergency Medicine, Logan Hospital, Loganholme, Queensland, AustraliaMarianne Wallis - School of Nursing and Midwifery, University of Sunshine Coast, Maroochydore, Queensland, Australia
- Publication Details
- Emergency Medicine Australasia, Vol.27(3), pp.216-224
- Publisher
- Wiley-Blackwell Publishing Asia; Australia
- Identifiers
- 991012927096302368
- Copyright
- This is an open access article under the terms of the Creative Commons AttributionNonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes
- Academic Unit
- Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article