The Effectiveness of Operating Fast Track by Board Certified Emergency Physician in Emergency Medical Center of Teaching Hospital

Jung, Jin Hee; Bae, Hyun A

Abstract

PURPOSE: The main reasons for overcrowding of the Emergency Department (ED) in Korea were delay in the department's decision making and entrance of non-emergency patients. The purpose of this study is to determine how primary care and in-hospital triage by board certified emergency physician can shorten the patients's length of stay and relieve overcrowding in the ED.
METHODS
A prospective analysis of patients who visited the ED of a 700-bed tertiary care teaching hospital during holidays from April 2, 2006 to October 3, 2006 was done. We differentiated patients into a fast tract group and a non-fast tract group. Data compared were lengths of stay, decision time, number of unscheduled returns, and patient disposition.
RESULTS
The patients in the fast track group have significantly shorter decision time than the 1,159 patients in the non-fast track group (p<0.01). The disposition decision time of the fast track group was shorter than the non-fast track group by an average of 29 minutes. The total residence time of the fast tract group was shorter by an average of 26 minutes than the non-fast tract group. The difference in decision time (disposition decision time and residence time) was larger in the patients that were discharged from the ED. There was no unscheduled return.
CONCLUSION
This study demonstrates that setting up a fast track system run by a board certified emergency physician could be one of the solutions in minimizing ED being crowding by patients with non-emergency problems. Fast track system could shorten total residence time about 26 minutes.