%0 Journal Article
%T The impact of a fast track area on quality and effectiveness outcomes: A Middle Eastern emergency department perspective
%A Subashnie Devkaran
%A Howard Parsons
%A Murray Van Dyke
%A Jonathan Drennan
%A Jaishen Rajah
%J BMC Emergency Medicine
%D 2009
%I BioMed Central
%R 10.1186/1471-227x-9-11
%X The study took place in a 500 bed, urban, tertiary care hospital in Abu Dhabi, United Arab Emirates. This was a quasi-experimental, which examined the impact of a FTA on a pre-intervention control group (January 2005) (n = 4,779) versus a post-intervention study group (January 2006) (n = 5,706).Mean WTs of Canadian Triage Acuity Scale (CTAS) 4 patients decreased by 22 min (95% CI 21 min to 24 min, P < 0.001). Similarly, mean WTs of CTAS 5 patients decreased by 28 min (95% CI 19 min to 37 min, P < 0.001) post FTA. The mean WTs of urgent patients (CTAS 2/3) were also significantly reduced after the FTA was opened (P < 0.001). The LWBS rate was reduced from 4.7% to 0.7% (95% CI 3.37 to 4.64; P < 0.001). Opening a FTA had no significant impact on mortality rates (P = 0.88).The FTA improved ED effectiveness (WTs and LOS) and quality measures (LWBS rates) whereas mortality rate remained unchanged.Emergency department (ED) overcrowding is becoming a ubiquitous manifestation representing an imbalance between the supply of medical resources and the demand by patients for quick and efficient service. It is a systemic and serious public health issue that affects industrialized countries all over the world [1-7]. Even though ED overcrowding has a multi-factorial origin that encompasses both internal and external factors, the use of EDs by non-urgent cases is also a contributing factor [1]. Therefore reducing the length of stay (LOS) and waiting times (WT) of non-urgent patients should contribute to a reduction in overcrowding.A proportion of patient morbidity and mortality can be attributed to delays in early diagnosis and treatment, especially with time-sensitive diagnoses such as myocardial infarction, pneumonia, sepsis, and stroke [8]. Thus even mild conditions have the potential to become more serious if patients do not receive early medical care or they leave without being seen (LWBS) [9]. Finally, overcrowding is a cause of dissatisfaction among patients who wait the long
%U http://www.biomedcentral.com/1471-227X/9/11