The impact of adding clinical assistants on patient waiting time in a crowded emergency department
Journal
Emergency Medicine Journal
Journal Volume
30
Journal Issue
12
Pages
1017-1019
Date Issued
2013
Author(s)
Abstract
Background: Emergency department (ED) crowding causes prolonged waiting times. Objective To evaluate the potential benefit of introducing clinical assistants to a busy and crowded ED. Methods: This was a retrospective cohort study at an urban, academic tertiary medical centre. We introduced one clinical assistant to each ED shift. The main task of clinical assistants was managing the flow of incoming ED patients. The case group consisted of all adult nontrauma emergency patients during the case period from 1 September to 30 November 2008. The first control group consisted of all adult non-trauma emergency patients between 1 June and 31 August 2008 and the second control group consisted of all patients treated between 1 September and 30 November 2007. The primary outcome was the 'waiting time' , defined as the time from triage to the time of the first medical order entered into the computer system. The secondary outcome was the number of adult non-trauma emergency patients who left the ED without being seen. Results: There were 12 257 cases and 25 950 controls. The mean and median waiting times were significantly shorter in the case group. The mean waiting time of the case group was 20.86 min, which was 4.51 min (17.8%) shorter than that of the first control group and 7.41 min (26.2%) shorter than that of the second control group. The median waiting time of the case group was also significantly shorter than those of the control groups. The number of the patients who left without being seen was signifi cantly smaller in the case period. Conclusions: In a busy and crowded ED, the introduction of clinical assistants to an existing emergency health service effectively reduces patient waiting times and decreases the number of patients leaving without being seen.
SDGs
Other Subjects
adult; article; clinical evaluation; cohort analysis; computer system; controlled study; crowding (area); emergency health service; emergency patient; emergency physician; emergency ward; female; hospital information system; human; injury; major clinical study; male; medical assistant; medical order; outcome assessment; patient satisfaction; priority journal; retrospective study; Taiwan; waiting room; administrative personnel; aged; emergency health service; hospital; manpower; middle aged; organization and management; personnel management; physician assistant; standards; time to treatment; young adult; Administrative Personnel; Adult; Aged; Crowding; Efficiency, Organizational; Emergency Service, Hospital; Female; Hospitals, Urban; Humans; Male; Middle Aged; Personnel Staffing and Scheduling; Physician Assistants; Retrospective Studies; Taiwan; Time-to-Treatment; Young Adult
Type
journal article