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Is the fast-track process efficient and safe for older adults admitted to the emergency department?
B Gasperini1, F Pierri2, E Espinosa3
1Department of Geriatrics and Rehabilitation, Santa Croce Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Viale Vittorio Veneto 2, 61032, Fano, Italy. beatricegasperini@hotmail.com.
Background:
The efficiency of the fast-track (FT) process in the management of patients in Emergency Departments is well demonstrated, but there is a lack of research focused on older adults. The aim of our study was to verify whether the FT process is efficient and safe for older adults admitted to ED.
Methods:
Observational case-control single-centre study.
Results:
Five hundred four cases and 504 controls were analysed. The mean age was 75 years, and there was a predominance of women. In total 96% of subjects were classified with a "less-urgent" tag. The length of stay was significantly lower in the fast-track group than in the control group (median 178 min, interquartile range 184 min, and 115 min, interquartile range 69 min, respectively, p < 0.001), as well as the time spent between the ED physician's visit and patient discharge (median 78 min, interquartile range 120 min, and median 3 min, interquartile range 6 min, respectively, p < 0.001). There weren't any increases in the number of unplanned readmissions within 48 h, 7 days and 30 days.
Conclusions:
The fast-track appears to be an efficient and safe strategy to improve the management of older adults admitted to the ED with minor complaints.
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