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  • Improved outcomes for emergency department patients whose ambulance off-stretcher time is not delayed

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    CrillyPUB646.pdf (185.2Kb)
    Author(s)
    Crilly, Julia
    Keijzers, Gerben
    Tippett, Vivienne
    O'Dwyer, John
    Lind, James
    Bost, Nerolie
    O'Dwyer, Marilla
    Shiels, Sue
    Wallis, Marianne
    Griffith University Author(s)
    Wallis, Marianne
    Crilly, Julia
    Keijzers, Gerben
    Year published
    2015
    Metadata
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    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 non-delayed presentations were compared. Logistic regression analysis was undertaken to identify predictors of an ED LOS of >4 ...
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    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 non-delayed 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 non-admitted 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.
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    Journal Title
    Emergency Medicine Australasia
    Volume
    27
    Issue
    3
    DOI
    https://doi.org/10.1111/1742-6723.12399
    Copyright Statement
    © 2015 The Authors. Emergency Medicine Australasia published by Wiley Publishing Asia Pty Ltd on behalf of Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
    Subject
    Public Health and Health Services not elsewhere classified
    Clinical Sciences
    Public Health and Health Services
    Publication URI
    http://hdl.handle.net/10072/125044
    Collection
    • Journal articles

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