Abualenain, Jameel

Alabdrabalnabi, Taibah

Levett, Paul

Pines, Jesse M.

Rasooly, Irit R.

English

George Washington University: Health Sciences Research Commons (HSRC)

printed by www.postersession.com The Impact Of Interventions To Reduce Length Of Stay In The Emergency Department: A Systematic Review  Jameel Abualenain MD MPH, Taibah Alabdrabalnabi MD, Irit Rasooly, Paul Levett MSc, Jesse M Pines MD MBA MSCE Department of Emergency Medicine, The George Washington University, Washington, D.C. •  Emergency department crowding is an increasing public health crisis in the U.S. and associated with negative outcomes, such as poor quality care, medical errors, inpatient complications, and higher mortality •  Over the past decade median ED lengths of stay have increased resulting in reductions in patient satisfaction and quality of care •  Interventions to improve crowding in the ED have mostly been tested in single sites •  The most common intervention is implementing operational process changes •  Adding extra providers, implementing operational process changes and using point of care testing have the greatest observed impact on length of stay.  •  Additional research is necessary to compare the effectiveness of interventions across settings  •  We conducted a systematic review of the literature to compare the effectiveness of ED-based interventions reporting comparative data on length of stay BACKGROUND OBJECTIVES RESULTS CONCLUSIONS Category Number of Studies Decreased  LOS Range for Decrease LOS (minutes) Operational Process 11 (26%) 9/11 10-116 Triage 9 (21%) 6/9 12-83 Point of Care 7 (17%) 5/7 8--114 Fast Track 6 (14%) 6/6 13-74 Extra Provider 5 (12%) 3/5 7-125 Other 5 (12%) 5/5 11-47 RESULTS •  43 unique studies included •  41 studies were single-center studies •  Annual visit volume ranged from 19-87K •  20 studies were time series  •  10 studies were quasi-experimental before & after  •  7 studies were randomized controlled trials  •  3 studies were case control studies •  3 studies used both mixed methods    METHODS DISCLOSURES  •  Pines – Funded by RWJF / Urgent Matters •  A systematic review using five databases from 1982 to 2013 •  Search terms including “Emergency Department”, “Crowding”, “length of stay”, and “Intervention”  •  Study inclusion was reviewed by two reviewers - disagreement was resolved by consensus •  Data were extracted using a standardized data extraction form  

The Impact of Interventions to Reduce Length of Stay in the Emergency Department: A Systematic Review

https://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=1061&context=libfacpres

The Impact of Interventions to Reduce Length of Stay in the Emergency Department: A Systematic Review

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George Washington University: Health Sciences Research Commons (HSRC)