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

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Crilly, Julia Keijzers, Gerben Tippett, Vivienne O'Dwyer, John Lind, James Bost, Nerolie O'Dwyer, Marilla Shiels, Sue Wallis, Marianne
Spatial Coverage	Queensland
Description	Country affiliation: Australia Author Affiliation: Crilly J ( Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.); Keijzers G ( Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.); Tippett V ( Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.); O'Dwyer J ( School of Medicine, Griffith University and Bond University, Gold Coast, Queensland, Australia.); Lind J ( School of Clinical Science, Queensland University of Technology, Brisbane, Queensland, Australia.); Bost N ( Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia.); O'Dwyer M ( Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.); Shiels S ( Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.); Wallis M ( Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia.)
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 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.
File Format	HTM / HTML
ISSN	17426731
e-ISSN	17426723
DOI	10.1111/1742-6723.12399
Journal	Emergency Medicine Australasia
Issue Number	3
Volume Number	27
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2015-06-01
Publisher Place	Australia
Access Restriction	Open
Subject Keyword	Discipline Emergency Medicine Ambulances Statistics & Numerical Data Emergency Service, Hospital Adolescent Child, Preschool Hospital Mortality Infant Length Of Stay Logistic Models Outcome And Process Assessment (health Care) Queensland Retrospective Studies Time Factors Time-to-treatment Triage Multicenter Study Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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