Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study

• Published in: Emergency medicine Australasia 2020-04, Vol.32 (2), p.271-280
• Main Authors: Crilly, Julia, Johnston, Amy NB, Wallis, Marianne, O'Dwyer, John, Byrnes, Joshua, Scuffham, Paul, Zhang, Ping, Bosley, Emma, Chaboyer, Wendy, Green, David
• Format: Article
• Language: English
• Subjects: advanced practice nurse; ambulance; emergency department; evaluation; Original Research; patient outcomes
• ISSN: 1742-6731; 1742-6723
• DOI: 10.1111/1742-6723.13407

Objective Extended delays in the transfer of patients from ambulance to ED can compromise patient flow. The present study aimed to describe the relationship between the use of an Emergency Department Ambulance Off‐Load Nurse (EDAOLN) role, ED processes of care and cost effectiveness. Methods This was a retrospective observational study over three periods of before (T1), during (T2) and after (T3) the introduction of the EDAOLN role in 2012. Ambulance, ED and cost data were linked and used for analysis. Processes of care measures analysed included: time to be seen by a doctor from ED arrival (primary outcome), ambulance‐ED offload compliance, proportion of patients seen within recommended triage timeframe, ED length of stay (LoS), proportion of patients transferred, admitted or discharged from the ED within 4 h and cost effectiveness. Results A total of 6045 people made 7010 presentations to the ED by ambulance over the study period. Several measures improved significantly between T1 and T2 including offload compliance (T1: 58%; T2: 63%), time to be seen (T1: 31 min; T2: 28 min), ED LoS (T1: 335 min; T2: 306 min), ED LoS