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New Intervention Model of Regional Transfer Network System to Alleviate Crowding of Regional Emergency Medical Center.

Ahn JY, Ryoo HW, Park J, Kim JK, Lee MJ, Kim JY, Shin SD, Cha WC, Seo JS, Kim YA - J. Korean Med. Sci. (2016)

Bottom Line: We found that the median ED length of stay (LOS) decreased significantly from 3.68 hours (interquartile range [IQR], 1.85 to 9.73) to 3.20 hours (IQR, 1.62 to 8.33) in the patient group after implementation of the Regional Transfer Network System (RTNS) (P < 0.001).The results of multivariate analysis showed a negative association between implementation of the RTNS and ED LOS (beta coefficient -0.743; 95% confidence interval -0.914 to -0.572; P < 0.001).In conclusion, the ED LOS in the tertiary hospital decreased after implementation of the RTNS.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea .

ABSTRACT
Emergency department (ED) crowding is a serious problem in most tertiary hospitals in Korea. Although several intervention models have been established to alleviate ED crowding, they are limited to a single hospital-based approach. This study was conducted to determine whether the new regional intervention model could alleviate ED crowding in a regional emergency medical center. This study was designed as a "before and after study" and included patients who visited the tertiary hospital ED from November 2011 to October 2013. One tertiary hospital and 32 secondary hospitals were included in the study. A transfer coordinator conducted inter-hospital transfers from a tertiary hospital to a secondary hospital for suitable patients. A total of 1,607 and 2,591 patients transferred from a tertiary hospital before and after the study, respectively (P < 0.001). We found that the median ED length of stay (LOS) decreased significantly from 3.68 hours (interquartile range [IQR], 1.85 to 9.73) to 3.20 hours (IQR, 1.62 to 8.33) in the patient group after implementation of the Regional Transfer Network System (RTNS) (P < 0.001). The results of multivariate analysis showed a negative association between implementation of the RTNS and ED LOS (beta coefficient -0.743; 95% confidence interval -0.914 to -0.572; P < 0.001). In conclusion, the ED LOS in the tertiary hospital decreased after implementation of the RTNS.

No MeSH data available.


Related in: MedlinePlus

Transfer process through the Regional Transfer Network System.
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Figure 1: Transfer process through the Regional Transfer Network System.

Mentions: This system is a combined information system established for follow-up monitoring of the patient’s treatment progress, separate from the medical record system of each hospital. The counterpart coordinator registers the transfer request form on the website when the attending physician of a tertiary hospital requests a transfer. The counterpart coordinator enters the progress record and the final disposition (discharge, death, or re-transfer), so that the tertiary hospital is privy to the patient’s care-progress status. Before registration at the web-based patient follow-up system, it was mandatory to obtain consent to collect and use personal information from all patients or guardians according to the Personal Information Protection Act in Korea. The transfer process through the RTNS is presented in Fig. 1.


New Intervention Model of Regional Transfer Network System to Alleviate Crowding of Regional Emergency Medical Center.

Ahn JY, Ryoo HW, Park J, Kim JK, Lee MJ, Kim JY, Shin SD, Cha WC, Seo JS, Kim YA - J. Korean Med. Sci. (2016)

Transfer process through the Regional Transfer Network System.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835610&req=5

Figure 1: Transfer process through the Regional Transfer Network System.
Mentions: This system is a combined information system established for follow-up monitoring of the patient’s treatment progress, separate from the medical record system of each hospital. The counterpart coordinator registers the transfer request form on the website when the attending physician of a tertiary hospital requests a transfer. The counterpart coordinator enters the progress record and the final disposition (discharge, death, or re-transfer), so that the tertiary hospital is privy to the patient’s care-progress status. Before registration at the web-based patient follow-up system, it was mandatory to obtain consent to collect and use personal information from all patients or guardians according to the Personal Information Protection Act in Korea. The transfer process through the RTNS is presented in Fig. 1.

Bottom Line: We found that the median ED length of stay (LOS) decreased significantly from 3.68 hours (interquartile range [IQR], 1.85 to 9.73) to 3.20 hours (IQR, 1.62 to 8.33) in the patient group after implementation of the Regional Transfer Network System (RTNS) (P < 0.001).The results of multivariate analysis showed a negative association between implementation of the RTNS and ED LOS (beta coefficient -0.743; 95% confidence interval -0.914 to -0.572; P < 0.001).In conclusion, the ED LOS in the tertiary hospital decreased after implementation of the RTNS.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea .

ABSTRACT
Emergency department (ED) crowding is a serious problem in most tertiary hospitals in Korea. Although several intervention models have been established to alleviate ED crowding, they are limited to a single hospital-based approach. This study was conducted to determine whether the new regional intervention model could alleviate ED crowding in a regional emergency medical center. This study was designed as a "before and after study" and included patients who visited the tertiary hospital ED from November 2011 to October 2013. One tertiary hospital and 32 secondary hospitals were included in the study. A transfer coordinator conducted inter-hospital transfers from a tertiary hospital to a secondary hospital for suitable patients. A total of 1,607 and 2,591 patients transferred from a tertiary hospital before and after the study, respectively (P < 0.001). We found that the median ED length of stay (LOS) decreased significantly from 3.68 hours (interquartile range [IQR], 1.85 to 9.73) to 3.20 hours (IQR, 1.62 to 8.33) in the patient group after implementation of the Regional Transfer Network System (RTNS) (P < 0.001). The results of multivariate analysis showed a negative association between implementation of the RTNS and ED LOS (beta coefficient -0.743; 95% confidence interval -0.914 to -0.572; P < 0.001). In conclusion, the ED LOS in the tertiary hospital decreased after implementation of the RTNS.

No MeSH data available.


Related in: MedlinePlus