Ten years of activity at a Portuguese University Hospital Emergency Department: a retrospective observational study

Detalhes bibliográficos
Autor(a) principal: Machado, Humberto S.
Data de Publicação: 2018
Outros Autores: Nunes, Catarina S., Marques, Antonio, Almeida, Isabel, Barros, Antonio Jose, Alves, Eurico Castro, Pereira, Antonio Sousa, Barros, Jose, Barbosa, Paulo
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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spelling 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
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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