USE OF PHYSICIAN EXTENDERS AND FAST TRACKS IN UNITED-STATES EMERGENCYDEPARTMENTS

To describe current practice regarding the use of physician extenders (PEs) and the ''fast track'' (FT) concept in United States emergency d epartments (EDs), a telephone survey of 250 US health care facilities offering emergency services was conducted. Of the EDs surveyed, 21.6% were using PEs at the time of the survey and of those not using PEs, 2 3.5% intended to do so within the next 2 years. Those using PEs had be en using them for a mean duration of 3.5 years (the mode was 2 years), The mean number of hours of PE coverage was 11.4 hours on weekdays an d 11.5 hours on weekends (the mode was 12 hours both on weekdays and w eekends). In general, the use of PEs increased with increasing hospita l size and ED census, in more urban settings, in teaching facilities, and in the Northeast region of the country. Thirty percent of EDs surv eyed had FT, and of those that did not have FT at the time of the surv ey, 32.8% intended to institute FT within 2 years. Of those that had F T, the mean number of years in use was 2.4 (the mode was 2). The use o f FT increased with increasing hospital size and ED census, in teachin g hospitals, and in the Northeast region. FT was most common in the su burban setting. The mean estimated percentage of ED patients going thr ough FT was 30.1%. The mean number of hours per day of FT operation wa s 13.4 hours on weekdays and 13.7 hours on weekends (the mode was 12 h ours/day both on weekdays and weekends), Of hospitals using PEs in the ED, 56.0% had FT; of hospitals without PEs in the ED, 23.5% had FT. C opyright (C) 1997 by W.B. Saunders Company.