Is achieving Ontario’s Emergency Department length of stay performance targets associated with improved patient outcomes following discharge? – February 2012

Posted on June 12, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, Emergency Medicine | Tags: |

Is achieving Ontario’s Emergency Department length of stay performance targets associated with improved patient outcomes following discharge? – February 2012

Michael Schull, Astrid Guttmann, Marian Vermeulan, Therese Stukel, & Dorina Simeonov. (2012).  Institute for Clinical Evaluative Sciences.

Extract:

“Background:
Wait time targets are controversial since some claim that the push for improved efficiency could compromise patient safety. On the other hand, spending long hours waiting for care in an ED has itself been shown to have safety risks. We tested the question of whether ED patients, who arrived during a shift when a greater percentage of all ED patients seen on that shift met their respective MOHLTC ED LOS targets, had a lower risk of mortality or hospital admission in the 7 days following ED discharge. We looked only at outcomes among patients discharged from the ED, since subsequent outcomes among admitted patients could be due to in-patient, as opposed to ED, care.  …

Policy recommendations:
Achieving MOHLTC ED wait time targets was associated with a reduced risk of death or hospitalization after ED discharge among both high and low acuity patients. This study provides empirical support for ED LOS targets as a means to improve patient outcomes. ED wait times performance should continue to be monitored. Consideration should be given to providing incentives for EDs to achieve 95% compliance with ED wait time targets, since this was generally associated with the best outcomes.”

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