Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department
Introduction: Critically ill patients are frequently transferred from other hospitals to the emergency departments (ED) of tertiary hospitals. Due to the unforeseen transfer, the ED length of stay (LOS) of the patient is likely to be prolonged in addition to other potentially adverse effects. In thi...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2022-10-01
|
| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/3rm506gq |
| _version_ | 1811179784680505344 |
|---|---|
| author | Sun Wook Moon Ji Hwan Lee Hyun Sim Lee Ha Yan Kim Myeongjee Lee Incheol Park Hyun Soo Chung Ji Hoon Kim |
| author_facet | Sun Wook Moon Ji Hwan Lee Hyun Sim Lee Ha Yan Kim Myeongjee Lee Incheol Park Hyun Soo Chung Ji Hoon Kim |
| author_sort | Sun Wook Moon |
| collection | DOAJ |
| description | Introduction: Critically ill patients are frequently transferred from other hospitals to the emergency departments (ED) of tertiary hospitals. Due to the unforeseen transfer, the ED length of stay (LOS) of the patient is likely to be prolonged in addition to other potentially adverse effects. In this study we sought to confirm whether the establishment of an organized unit — the Emergency Transfer Coordination Center (ETCC) — to systematically coordinate emergency transfers would be effective in reducing the ED LOS of transferred, critically ill patients. Methods: The present study is a retrospective observational study focusing on patients who were transferred from other hospitals and admitted to the intensive care unit (ICU) of the ED in a tertiary hospital located in northwestern Seoul, the capital city of South Korea, from January 2019 – December 2020. The exposure variable of the study was ETCC approval before transfer, and ED LOS was the primary outcome. We used propensity score matching for comparison between the group with ETCC approval and the control group. Results: Included in the study were 1,097 patients admitted to the ICU after being transferred from other hospitals, of whom 306 (27.9%) were transferred with ETCC approval. The median ED LOS in the ETCC-approved group was significantly reduced to 277 minutes compared to 385 minutes in the group without ETCC approval. The ETCC had a greater effect on reducing evaluation time than boarding time, which was the same for populations with different clinical features. Conclusion: An ETCC can be effective in systematically reducing the ED LOS of critically ill patients who are transferred from other hospitals to tertiary hospitals that are experiencing severe crowding. |
| first_indexed | 2024-04-11T06:40:29Z |
| format | Article |
| id | doaj.art-70ea595b4caa4fbba6aeaf683e25103b |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-04-11T06:40:29Z |
| publishDate | 2022-10-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-70ea595b4caa4fbba6aeaf683e25103b2022-12-22T04:39:34ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182022-10-0123610.5811/westjem.2022.8.56039wjem-23-846Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency DepartmentSun Wook Moon0Ji Hwan Lee1Hyun Sim Lee2Ha Yan Kim3Myeongjee Lee4Incheol Park5Hyun Soo Chung6Ji Hoon Kim7Yonsei University College of Medicine, Department of Emergency Medicine, Seoul, the Republic of KoreaYonsei University College of Medicine, Department of Emergency Medicine, Seoul, the Republic of KoreaYonsei University Health System, Department of Emergency Nursing, Seoul, the Republic of KoreaYonsei University College of Medicine, Department of Biomedical Systems Informatics, Seoul, the Republic of KoreaYonsei University College of Medicine, Department of Biomedical Systems Informatics, Seoul, the Republic of KoreaYonsei University College of Medicine, Department of Emergency Medicine, Seoul, the Republic of KoreaYonsei University College of Medicine, Department of Emergency Medicine, Seoul, the Republic of KoreaYonsei University College of Medicine, Department of Emergency Medicine, Seoul, the Republic of KoreaIntroduction: Critically ill patients are frequently transferred from other hospitals to the emergency departments (ED) of tertiary hospitals. Due to the unforeseen transfer, the ED length of stay (LOS) of the patient is likely to be prolonged in addition to other potentially adverse effects. In this study we sought to confirm whether the establishment of an organized unit — the Emergency Transfer Coordination Center (ETCC) — to systematically coordinate emergency transfers would be effective in reducing the ED LOS of transferred, critically ill patients. Methods: The present study is a retrospective observational study focusing on patients who were transferred from other hospitals and admitted to the intensive care unit (ICU) of the ED in a tertiary hospital located in northwestern Seoul, the capital city of South Korea, from January 2019 – December 2020. The exposure variable of the study was ETCC approval before transfer, and ED LOS was the primary outcome. We used propensity score matching for comparison between the group with ETCC approval and the control group. Results: Included in the study were 1,097 patients admitted to the ICU after being transferred from other hospitals, of whom 306 (27.9%) were transferred with ETCC approval. The median ED LOS in the ETCC-approved group was significantly reduced to 277 minutes compared to 385 minutes in the group without ETCC approval. The ETCC had a greater effect on reducing evaluation time than boarding time, which was the same for populations with different clinical features. Conclusion: An ETCC can be effective in systematically reducing the ED LOS of critically ill patients who are transferred from other hospitals to tertiary hospitals that are experiencing severe crowding.https://escholarship.org/uc/item/3rm506gq |
| spellingShingle | Sun Wook Moon Ji Hwan Lee Hyun Sim Lee Ha Yan Kim Myeongjee Lee Incheol Park Hyun Soo Chung Ji Hoon Kim Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department Western Journal of Emergency Medicine |
| title | Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department |
| title_full | Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department |
| title_fullStr | Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department |
| title_full_unstemmed | Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department |
| title_short | Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department |
| title_sort | effects of emergency transfer coordination center on length of stay of critically ill patients in the emergency department |
| url | https://escholarship.org/uc/item/3rm506gq |
| work_keys_str_mv | AT sunwookmoon effectsofemergencytransfercoordinationcenteronlengthofstayofcriticallyillpatientsintheemergencydepartment AT jihwanlee effectsofemergencytransfercoordinationcenteronlengthofstayofcriticallyillpatientsintheemergencydepartment AT hyunsimlee effectsofemergencytransfercoordinationcenteronlengthofstayofcriticallyillpatientsintheemergencydepartment AT hayankim effectsofemergencytransfercoordinationcenteronlengthofstayofcriticallyillpatientsintheemergencydepartment AT myeongjeelee effectsofemergencytransfercoordinationcenteronlengthofstayofcriticallyillpatientsintheemergencydepartment AT incheolpark effectsofemergencytransfercoordinationcenteronlengthofstayofcriticallyillpatientsintheemergencydepartment AT hyunsoochung effectsofemergencytransfercoordinationcenteronlengthofstayofcriticallyillpatientsintheemergencydepartment AT jihoonkim effectsofemergencytransfercoordinationcenteronlengthofstayofcriticallyillpatientsintheemergencydepartment |