What Impact Does Implementation of an Emergency Department Information System Have on Emergency Department Processes?

2.50
Hdl Handle:
http://hdl.handle.net/10755/163010
Type:
Presentation
Title:
What Impact Does Implementation of an Emergency Department Information System Have on Emergency Department Processes?
Abstract:
What Impact Does Implementation of an Emergency Department Information System Have on Emergency Department Processes?
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Kaufman, Douglas, RN, BSN, CEN
P.I. Institution Name:Mercy Hospital of Pittsburgh
Title:Manager, Department of Emergency Medicine
Contact Address:1400 Locust Street, Pittsburgh, PA, 15219, USA
Contact Telephone:(412) 232-8374
Co-Authors:Bruce MacLeod, MD, FACEP; Pamela Cockley, RN, BSN, CEN, CCRC; Kaveh Ilkhanipour, MD, FACEP; Frank D?Amico, PhD
Purpose: Emergency department (ED) issues regarding difficulty tracking patients and long lengths of stay (LOS) are well documented. The purpose of this study was to evaluate the impact of a three-phase implementation of an emergency department information system (EDIS) on ED throughput times and related processes. The main outcome measure was patient LOS in the emergency department. Design/Setting: This was an interventional, longitudinal time series design study conducted in an urban, Level 1 trauma center with 45,000 annual visits. Participants: 1,728 ED patients, Time 0 (T0) with n=876 and Time 1 (T1) with n=852) presenting during seven randomized 24 hour periods representing each day of the week during a one-month time frame pre- and post-implementation of the EDIS were included. Patients who left without treatment (LWOT: T0 [n=18], T1 [n=25]) and patients with incomplete throughput time data were excluded (T0 [n=16], T1 [n=2]). Participants were 45.1% male, 64.9% Caucasian, 32.3% African-Americans, with a mean age of 39.8 years. Disposition status included 26.7% admissions, 72.4% discharged, and 0.8% transferred. Methods: Throughput times were compared for pre- and post-implementation time points along with selected radiological studies. Basic parametric and nonparametric statistics were used. Results: Time from arrival to triage was 0.41 hours for T0 vs. 0.36 hours for T1 (p=NS). Time from arrival to registration was 1.38 hours for T0 vs. 0.56 hours for T1 (p=.0001). Time from arrival to treatment room was 1.01 hours for T0 vs. 1.12 hours for T1 (p=NS). The average LOS in T0 was 3.67 hours vs. 4.46 hours in T1 (p=.0001). Time from arrival to admission decision was 3.04 hours (T0, SD 1.9) vs. 3.48 hours (T1, SD 2.4) (p=.038). Chest radiograph turn-around-time was 0.57 hours for T0 vs. 0.64 hours for T1 (p=NS). Recommendations: Preliminary results from the first phase of EDIS implementation do not appear to have a beneficial effect on overall throughput times. It is not clear whether this was an effect of the implementation of the EDIS system or other variables external to the ED. Given that this study evaluated data over after one month of implementation, further data collection is warranted and would be interesting to look at results at six and twelve months follow ups.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleWhat Impact Does Implementation of an Emergency Department Information System Have on Emergency Department Processes?en_GB
dc.identifier.urihttp://hdl.handle.net/10755/163010-
dc.description.abstract<table><tr><td colspan="2" class="item-title">What Impact Does Implementation of an Emergency Department Information System Have on Emergency Department Processes?</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kaufman, Douglas, RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mercy Hospital of Pittsburgh</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Manager, Department of Emergency Medicine</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1400 Locust Street, Pittsburgh, PA, 15219, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(412) 232-8374</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dkaufman@mercy.pmhs.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Bruce MacLeod, MD, FACEP; Pamela Cockley, RN, BSN, CEN, CCRC; Kaveh Ilkhanipour, MD, FACEP; Frank D?Amico, PhD</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Emergency department (ED) issues regarding difficulty tracking patients and long lengths of stay (LOS) are well documented. The purpose of this study was to evaluate the impact of a three-phase implementation of an emergency department information system (EDIS) on ED throughput times and related processes. The main outcome measure was patient LOS in the emergency department. Design/Setting: This was an interventional, longitudinal time series design study conducted in an urban, Level 1 trauma center with 45,000 annual visits. Participants: 1,728 ED patients, Time 0 (T0) with n=876 and Time 1 (T1) with n=852) presenting during seven randomized 24 hour periods representing each day of the week during a one-month time frame pre- and post-implementation of the EDIS were included. Patients who left without treatment (LWOT: T0 [n=18], T1 [n=25]) and patients with incomplete throughput time data were excluded (T0 [n=16], T1 [n=2]). Participants were 45.1% male, 64.9% Caucasian, 32.3% African-Americans, with a mean age of 39.8 years. Disposition status included 26.7% admissions, 72.4% discharged, and 0.8% transferred. Methods: Throughput times were compared for pre- and post-implementation time points along with selected radiological studies. Basic parametric and nonparametric statistics were used. Results: Time from arrival to triage was 0.41 hours for T0 vs. 0.36 hours for T1 (p=NS). Time from arrival to registration was 1.38 hours for T0 vs. 0.56 hours for T1 (p=.0001). Time from arrival to treatment room was 1.01 hours for T0 vs. 1.12 hours for T1 (p=NS). The average LOS in T0 was 3.67 hours vs. 4.46 hours in T1 (p=.0001). Time from arrival to admission decision was 3.04 hours (T0, SD 1.9) vs. 3.48 hours (T1, SD 2.4) (p=.038). Chest radiograph turn-around-time was 0.57 hours for T0 vs. 0.64 hours for T1 (p=NS). Recommendations: Preliminary results from the first phase of EDIS implementation do not appear to have a beneficial effect on overall throughput times. It is not clear whether this was an effect of the implementation of the EDIS system or other variables external to the ED. Given that this study evaluated data over after one month of implementation, further data collection is warranted and would be interesting to look at results at six and twelve months follow ups.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:59Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:59Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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