Fast Track by physician assistants shortens waiting and turnaround times of trauma patients in an emergency department.

Abstract

We sought to determine whether the introduction of a separate patient flow comprising patients with simple, non-complex health issues [Fast Track (FT)] in a Dutch emergency department setting (ED), without the introduction of additional staff, and treated by a physician assistant, would have favourable effects on waiting and turnaround times without deleterious effects for patients with a higher urgency. We used a prospective comparative intervention design for our study. The waiting times and length of stay for surgical and orthopaedic patients in the ED were measured and compared 3months before and 3months after the introduction of FT. During the study period, 1,289 patients were treated before, and 1,393 after the introduction of FT. After the introduction of FT, we observed a decrease of 12min (13%) in the median length of stay for the total group. The median waiting time decreased by 41min (69%). The group comprising patients with low to moderate urgency levels showed a median reduction of 12min in length of stay, whereas the length of stay for urgent patients was reduced by 19min. The waiting time for the low to moderate urgency patients decreased by 68min, while the urgent patient group showed a reduction of 32min. The introduction of FT performed by a physician assistant resulted in a significant drop in waiting time and length of stay in a Dutch ED setting. This reduction was realised without the allocation of additional staff and even reduced waiting and turnaround times for the patients with a high urgency.