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Pilot study of metropolitan emergency department workload complexity
1Acute Demand Management Unit, State Health Emergency Services, Health Department of Western Australia, Fremantle, Australia. peter.sprivulis@health.wa.gov.au
Objective:
Assessment of emergency department (ED) patient complexity using the number of procedures, investigations or consultations (PICsum).
Methods:
Retrospective analysis of 12 months of data from an adult metropolitan teaching hospital ED.
Results:
A bimodal distribution of PICsum (modal peaks, PICsum 1 and 7) was observed in all Australasian Triage Scale, disposition, mode of arrival, age and referral source groups. Patients requiring a minimum of two procedures or a minimum of two investigations or a minimum of two consultations (Min2 patients) comprised 59% (95% CI 58.5-59.5) of total patients 93% (95% CI 92.5-93.8) of total PICsum. Age is highly correlated with Mean PICsum (Pearson r = 0.98, P < 0.001) and the proportion of Min2 patients (Pearson r = 0.98, P < 0.001).
Conclusions:
An intuitive partition in the complexity distribution is identified at up to one procedure, one investigation and one consultation. Patient age is correlated with complexity and ED age distribution may be a useful proxy for complexity, particularly if used in conjunction with validated age versus complexity tables.