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Number of Consults and Response Times to ED: Effects on Patient Flow and Outcomes
Objectives:
'he number of consults and response times to our Emergency Department (ED) were tracked to understand the effects on patient flow and outcomes.
Study Design:
We conducted a prospective observational study using convenience samples.
Methods:
There were 992 requests for physician consultations or logistical services (bed manager, transport, or room cleaning) logged during ED shifts from January through July, 2014 at the VA CT Healthcare System West Haven Campus (VACHS). Services were paged every 15 minutes until a response was received; the total response time was then recorded. One-hundred-eighty-six requests were triggered by one author's cohort of 392 patients, for which age, disposition, and outcomes were also tracked.
Results:
The median response times were one to six minutes depending on the service requested; outli- ers exceeded an hour. A patient's ED stay duration increased with the number of services paged. The number of services paged was associated with mortality despite adjusting for age, ED waiting time, ED total time, and disposition (odds ratio = 3.14, P = .02) although comorbidity scores were not tracked.
Conclusions:
Response time to ED pages varies widely. The number of services paged correlated with ED length of stay and possibly inpatient mortality.
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