Factors affecting the length of stay in the emergency department for critically Ill patients transferred to regional emergency medical center.
Hyungbok Lee, Sangrim Lee, Hyeoneui Kim
PMID 36575810WHAT IT FOUND
Transferred critically ill patients who needed ICU admission, emergency operation or angiography, fewer consultations, or severe emergency disease were more likely to leave the emergency department within 6 hours; re-transfer and more consultations were linked to longer stay.
Key findings
01In the combined KTAS level 1 and 2 model, staying 6 hours or less was more likely with fewer consultations, fewer diagnoses, severe emergency disease, emergency operation or angiography, and ICU admission; it was less likely with a disease-related visit and re-transfer.
02For KTAS level 1 patients, ICU admission, fewer consultations, and circulatory disease were significant predictors of shorter ED length of stay.
03Hand-off communication was not an independent predictor in the logistic model, but mean ED stays were shorter with hand-off communication for same-area referrals, level 1 patients, patients needing emergency operation or angiography, and patients needing ICU admission.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one 1761-bed tertiary hospital, so the factors may not apply to other hospitals. It included only transferred patients triaged as KTAS level 1 or 2, so it does not tell what happens for less urgent patients or non-transferred patients. It did not measure mortality, medical costs, or final patient outcomes, so it cannot show whether shorter ED stay helped patients. It was a retrospective record analysis and did not assign treatments, so it cannot prove that any factor caused a shorter or longer stay.
The easy way to misread this
Do not conclude that inter-hospital hand-off communication causes shorter ED length of stay. It was not an independent predictor in the logistic model, and the shorter stays seen in some subgroups are observational associations from one hospital.