CONTINUOUS QUALITY IMPROVEMENT REDUCES LENGTH OF STAY FOR FAST-TRACK PATIENTS IN AN EMERGENCY DEPARTMENT

Objective: To demonstrate how continuous quality improvement (CQI) can identify rational and effective means to reduce length of stay for mi nor illness/injury in an ED. Methods: A CQI team documented the proces s of fast-track (FT) patient flow and prioritized the causes of delay. In Phase I, two solutions were implemented, In this Phase II of the s tudy, three changes were implemented, including expansion of the FT ar ea, realignment to provide a full-time FT nurse, and a detailed, stric ter triage classification. The outcome was assessed by examining the i nterval from presentation to release from the ED (length of stay; LOS) . Differences were ascertained by analysis of variance for consecutive FT patients not requiring radiography, EGG, or blood testing. Interva ls from three pre-Phase II intervention 48-hour periods and one post-P hase II intervention 48-hour period were analyzed. Results: Before the Phase I changes, the mean +/- SD LOS was 92 +/- 46 min. After the Pha se I changes, the LOS was 67 +/- 31 min, After the Phase II changes, t his was reduced to 57 +/- 34 min (p < 0.05). Conclusion: The formal ap plication of CQI techniques in the ED can change patient flow and redu ce LOS for FT patients.