Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.2/13912 |
Resumo: | Background: Emergency department (ED) management relies on real-time information. Patient flow, lengthof-stay (LOS), complaint related readmissions, and patients that leave without being seen (LWBS), are monitoring parameters. The objective of this study was to evaluate activity time trends regarding ED at Centro Hospitalar do Porto from 2007 to 2016. Methods: Analysis of ED data warehouse (Alert® Emergency Room) was carried out. Manchester Triage System (MTS) is used, and the mentioned priorities (P1, P2, P3, P4 and P5) correspond to its terminology. Spearman correlation between variables was applied. Results: Patient records from 1.256.900 ED visits were evaluated. ED demand increased 16%. Priority 2 increased by 50% (p<0.001). A decrease of priority 4 (p<0.001) was observed. Patients that visit ED for unrelated reasons (labeled white) decreased (p<0.001). Difference between patients’ medians at different day hours (p<0.001) was found. A steady peak influx between 10 h-11 h and 14 h-16 h was found and significant increase was observed during night/dawn hours (3-8 h). No differences were observed between weekdays affluence. A priority difference was observed in weekdays, with a Monday peak for P3 and P4 priorities (p<0.001). A decrease in all patients’ ages was observed till sixty years old (p<0.001); A raise was noticed after eighty years old (p<0.001). Nevertheless, the LWBS was kept under 2.5% LOS under 5 h 30 m, with a sustained time-to-first-medical-observation (TFMO) under 70 minutes. Complaint indexed to readmissions (CIR) remained constant. Discussion: A constant LOS, TFMO, CIR, and small LWBS indicate a positive trend of ED clinical management. Population’s characteristics should be taken in to consideration to maintain these results. Conclusions: ED affluence increased during the studied period, especially by the older and the sicker. Primary care increased availability did not influence ED demand. Real time data storage helped to maintain clinical management by evidence based decisions |
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Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational studyEmergency department managementCrowdingLengthof-stayEmergency department readmissionsBackground: Emergency department (ED) management relies on real-time information. Patient flow, lengthof-stay (LOS), complaint related readmissions, and patients that leave without being seen (LWBS), are monitoring parameters. The objective of this study was to evaluate activity time trends regarding ED at Centro Hospitalar do Porto from 2007 to 2016. Methods: Analysis of ED data warehouse (Alert® Emergency Room) was carried out. Manchester Triage System (MTS) is used, and the mentioned priorities (P1, P2, P3, P4 and P5) correspond to its terminology. Spearman correlation between variables was applied. Results: Patient records from 1.256.900 ED visits were evaluated. ED demand increased 16%. Priority 2 increased by 50% (p<0.001). A decrease of priority 4 (p<0.001) was observed. Patients that visit ED for unrelated reasons (labeled white) decreased (p<0.001). Difference between patients’ medians at different day hours (p<0.001) was found. A steady peak influx between 10 h-11 h and 14 h-16 h was found and significant increase was observed during night/dawn hours (3-8 h). No differences were observed between weekdays affluence. A priority difference was observed in weekdays, with a Monday peak for P3 and P4 priorities (p<0.001). A decrease in all patients’ ages was observed till sixty years old (p<0.001); A raise was noticed after eighty years old (p<0.001). Nevertheless, the LWBS was kept under 2.5% LOS under 5 h 30 m, with a sustained time-to-first-medical-observation (TFMO) under 70 minutes. Complaint indexed to readmissions (CIR) remained constant. Discussion: A constant LOS, TFMO, CIR, and small LWBS indicate a positive trend of ED clinical management. Population’s characteristics should be taken in to consideration to maintain these results. Conclusions: ED affluence increased during the studied period, especially by the older and the sicker. Primary care increased availability did not influence ED demand. Real time data storage helped to maintain clinical management by evidence based decisionsIOMCRepositório AbertoMachado, Humberto S.Nunes, Catarina S.Marques, AntonioAlmeida, IsabelBarros, Antonio JoseAlves, Eurico CastroPereira, Antonio SousaBarros, JoseBarbosa, Paulo2023-05-30T14:01:22Z20182018-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.2/13912engMachado HS, Nunes C, Marques A, Almeida I, Barros AJ, et al. (2018) Ten Years of Activity at a Portuguese University Hospital Emergency Department: A Retrospective Observational Study. Gen Med (Los Angel) 6: 3092327-514610.4172/2327-5146.1000309info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-16T15:46:26Zoai:repositorioaberto.uab.pt:10400.2/13912Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:52:52.576821Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study |
title |
Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study |
spellingShingle |
Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study Machado, Humberto S. Emergency department management Crowding Lengthof-stay Emergency department readmissions |
title_short |
Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study |
title_full |
Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study |
title_fullStr |
Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study |
title_full_unstemmed |
Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study |
title_sort |
Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study |
author |
Machado, Humberto S. |
author_facet |
Machado, Humberto S. Nunes, Catarina S. Marques, Antonio Almeida, Isabel Barros, Antonio Jose Alves, Eurico Castro Pereira, Antonio Sousa Barros, Jose Barbosa, Paulo |
author_role |
author |
author2 |
Nunes, Catarina S. Marques, Antonio Almeida, Isabel Barros, Antonio Jose Alves, Eurico Castro Pereira, Antonio Sousa Barros, Jose Barbosa, Paulo |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Aberto |
dc.contributor.author.fl_str_mv |
Machado, Humberto S. Nunes, Catarina S. Marques, Antonio Almeida, Isabel Barros, Antonio Jose Alves, Eurico Castro Pereira, Antonio Sousa Barros, Jose Barbosa, Paulo |
dc.subject.por.fl_str_mv |
Emergency department management Crowding Lengthof-stay Emergency department readmissions |
topic |
Emergency department management Crowding Lengthof-stay Emergency department readmissions |
description |
Background: Emergency department (ED) management relies on real-time information. Patient flow, lengthof-stay (LOS), complaint related readmissions, and patients that leave without being seen (LWBS), are monitoring parameters. The objective of this study was to evaluate activity time trends regarding ED at Centro Hospitalar do Porto from 2007 to 2016. Methods: Analysis of ED data warehouse (Alert® Emergency Room) was carried out. Manchester Triage System (MTS) is used, and the mentioned priorities (P1, P2, P3, P4 and P5) correspond to its terminology. Spearman correlation between variables was applied. Results: Patient records from 1.256.900 ED visits were evaluated. ED demand increased 16%. Priority 2 increased by 50% (p<0.001). A decrease of priority 4 (p<0.001) was observed. Patients that visit ED for unrelated reasons (labeled white) decreased (p<0.001). Difference between patients’ medians at different day hours (p<0.001) was found. A steady peak influx between 10 h-11 h and 14 h-16 h was found and significant increase was observed during night/dawn hours (3-8 h). No differences were observed between weekdays affluence. A priority difference was observed in weekdays, with a Monday peak for P3 and P4 priorities (p<0.001). A decrease in all patients’ ages was observed till sixty years old (p<0.001); A raise was noticed after eighty years old (p<0.001). Nevertheless, the LWBS was kept under 2.5% LOS under 5 h 30 m, with a sustained time-to-first-medical-observation (TFMO) under 70 minutes. Complaint indexed to readmissions (CIR) remained constant. Discussion: A constant LOS, TFMO, CIR, and small LWBS indicate a positive trend of ED clinical management. Population’s characteristics should be taken in to consideration to maintain these results. Conclusions: ED affluence increased during the studied period, especially by the older and the sicker. Primary care increased availability did not influence ED demand. Real time data storage helped to maintain clinical management by evidence based decisions |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018 2018-01-01T00:00:00Z 2023-05-30T14:01:22Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.2/13912 |
url |
http://hdl.handle.net/10400.2/13912 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Machado HS, Nunes C, Marques A, Almeida I, Barros AJ, et al. (2018) Ten Years of Activity at a Portuguese University Hospital Emergency Department: A Retrospective Observational Study. Gen Med (Los Angel) 6: 309 2327-5146 10.4172/2327-5146.1000309 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
IOMC |
publisher.none.fl_str_mv |
IOMC |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799135122923978752 |