FAST TRACKING PATIENTS IN AN URBAN PEDIATRIC EMERGENCY DEPARTMENT

Modern health care reform emphasizes efficient resource and facility m anagement and the need to develop strategies to direct patients with l ower-acuity concerns away from the relatively cost inefficient full-se rvice pediatric emergency department (ED). This study examined a pedia tric fast track system for triage accuracy and turnaround times, Egles ton Childrens Hospital is a regional, urban, tertiary care academic ce nter which is a major teaching affiliate of Emery University School of Medicine, The pediatric ED has an annual census of more than 30,000 p atient encounters, During the g-month period from December 1993 throug h August 1994, 2,243 lower-acuity patients were evaluated in the fast track section of the ED, Patients assigned to the fast track system ma intained a quicker turnaround time than the aggregate of all patients seen in the ED (107 [95% CI 0, 245] minutes versus 149 [95% CI 0, 341] minutes, P < .01), Their total turnaround time was also less than tha t for patients with similar acuity levels seen during the hours that t he fast track system was not in operation (120 [95% CI 0, 300 minutes] , P < .01), Only 63 of the 2,243 (2.8%) patients assigned to fast trac k were found to have higher acuity levels than suspected at initial tr iage, In all cases they were appropriately cared for in the fast track area, The fast track system appears to be an effective method by whic h an urban pediatric ED can efficiently maintain patient flow in light of limited resources, space constraints, limited manpower, and an inc reasing census. (Am J Emerg Med 1996;14:242-244, Copyright (C) 1996 by W.B. Saunders Company)