Authors: Elias Youssef, Roshanak Benabbas, Brittany Choe, Donald Doukas, Hope A Taitt, Rajesh Verma, Shahriar Zehtabchi
Published in: Academic Emergency Medicine, June 4, 2024
Conclusions: Interventions such as triage liaison physicians and POC testing were found to be effective in reducing TTD and LWBS rates, suggesting that targeted operational strategies can significantly improve ED throughput and care delivery. Tailoring these strategies to specific ED environments can optimize their effectiveness. Further research should explore the integration and scalability of these interventions across various healthcare settings.
Methods:
- Type: Systematic review and meta-analysis
- Data Sources: MEDLINE, EMBASE, and other databases were searched for relevant studies.
- Study Selection: Included were randomized controlled trials (RCTs) assessing non-disease-specific interventions in EDs.
- Data Extraction and Synthesis: Utilized Cochrane's risk of bias tool and GRADE for quality assessment. A random-effects model was applied for meta-analysis.
- Outcomes: Changes in TTD, TTP, and LWBS.
Results:
- Study Inclusion: 20 RCTs met inclusion criteria from 1850 references screened.
- Key Interventions: Triage liaison physician, point-of-care (POC) testing, expedited workups, medical scribes, triage kiosks, and notification systems.
- POC Testing: Showed a reduction in TTD by 5-96 minutes (high heterogeneity) but increased TTP by 2 minutes (95% CI: 0.6-4 min).
- Triage Liaison Physician: Decreased TTD by 28 minutes (95% CI: 19-37 min) and reduced LWBS rates (RR: 0.76, 95% CI: 0.66-0.88).