Interprofessional teamwork versus fast track streaming in an emergency department - An observational cohort study of two strategies for enhancing the throughput of orthopedic patients presenting limb injuries or back pain

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Liu, JennyKarolinska Institutet (author)

Interprofessional teamwork versus fast track streaming in an emergency department - An observational cohort study of two strategies for enhancing the throughput of orthopedic patients presenting limb injuries or back pain

Article/chapterEnglish2019

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2019-07-18
Public Library of Science,2019
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LIBRIS-ID:oai:DiVA.org:lnu-89264
https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-89264URI
https://doi.org/10.1371/journal.pone.0220011DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:141690561URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Objective To compare two strategies, interprofessional teams versus fast track streaming, for orthopedic patients with limb injuries or back pain, the most frequent orthopedic complaints in an emergency department. Methods An observational before-and-after study at an adult emergency department from May 2012 to Nov 2015. Patients who arrived on weekdays from 8 am to 9 pm and presented limb injury or back pain during one year of each process were included, so that 11,573 orthopedic presentations were included in the fast track period and 10,978 in the teamwork period. Similarly, another 11,020 and 10,760 arrivals presenting the six most frequent non-orthopedic complaints were included in the respective periods, altogether 44,331 arrivals. The outcome measures were the time to physician (TTP) and length of stay (LOS). The LOS was adjusted for predictors, including imaging times, by using linear regression analysis. Results The overall median TTP was shorter in the teamwork period, 76.3 min versus 121.0 min in the fast track period (-44.7 min, 95% confidence interval (CI): -47.3 to -42.6). The crude median LOS for orthopedic presentations was also shorter in the teamwork period, 217.0 min versus 230.0 min (-13.0 min, 95% CI: -18.0 to -8.0), and the adjusted LOS was 22.8 min shorter (95% CI: -26.9 to -18.7). For non-orthopedic presentations, the crude median LOS did not differ significantly between the periods (2.0 min, 95% CI: -3.0 to 7.0). However, the adjusted LOS was shorter in the teamwork period (-20.1 min, 95% CI: -24.6 to -15.7). Conclusions The median TTP and LOS for orthopedic presentations were shorter in the teamwork period. For non-orthopedic presentations, the TTP and adjusted LOS were also shorter in the teamwork period. Therefore, interprofessional teamwork may be an alternative approach to improve the patient flow in emergency departments.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng
Health and Caring Sciences
Hälsovetenskap

Added entries (persons, corporate bodies, meetings, titles ...)

Masiello, Italo,Professor,1969-Linnéuniversitetet,Institutionen för pedagogik och lärande (PEL),Karolinska Institutet, Sweden;Södersjukhuset, Sweden(Swepub:lnu)itmaaa (author)
Ponzer, SariKarolinska Institutet (author)
Farrokhnia, NasimKarolinska Institutet, Sweden;Södersjukhuset, Sweden (author)
Karolinska InstitutetInstitutionen för pedagogik och lärande (PEL) (creator_code:org_t)

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In:PLOS ONE: Public Library of Science14:7, s. -161932-6203

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Health Care Serv ...

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