An interrupted time-series analysis of the impact of emergency department reconfiguration on regional emergency department trolley numbers in Ireland from 2005 to 2015

• Published in: BMJ open 2019-09, Vol.9 (9), p.e029261-e029261
• Main Authors: Lynch, Brenda, Browne, John, Buckley, Claire Mary, Healy, Orla, Corcoran, Paul, Fitzgerald, Anthony P
• Format: Article
• Language: English
• Subjects: Computer simulation; Departments; Emergency medical care; Health services; Health Services Research; Hospital systems; Hospitals; Population; Surgery; Systematic review; Time series
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2019-029261

ObjectivesTo understand the impact of emergency department (ED) reconfiguration on the number of patients waiting for hospital beds on trolleys in the remaining EDs in four geographical regions in Ireland using time-series analysis.SettingEDs in four Irish regions; the West, North-East, South and Mid-West from 2005 to 2015.ParticipantsAll patients counted as waiting on trolleys in an ED for a hospital bed in the study hospitals from 2005 to 2015.InterventionThe system intervention was the reconfiguration of ED services, as determined by the Department of Health and Health Service Executive. The timing of these interventions varied depending on the hospital and region in question.ResultsThree of the four regions studied experienced a significant change in ED trolley numbers in the 12-month post-ED reconfiguration. The trend ratio before and after the intervention for these regions was as follows: North-East incidence rate ratio (IRR) 2.85 (95% CI 2.04 to 3.99, p