Effect of emergency department fast track on emergency department length of stay: a case-control study

OBJECTIVE: To examine the effect of fast track on emergency department (ED) length of stay (LOS).

DESIGN AND SETTING: Pair-matched case-control design in a public teaching hospital in metropolitan Melbourne, Australia.

PARTICIPANTS: Patients treated by the ED fast track (cases) between 1 January and 31 March 2007 were compared with patients treated by the usual ED processes (controls) from 1 July to 15 November 2006 (n = 822 matched pairs).

INTERVENTION: ED fast track was established in November 2006 and focused on the management of patients with non-urgent complaints.

MAIN OUTCOME MEASURES: The primary outcome measure was ED LOS for fast-track patients. Secondary outcomes were waiting times and ED LOS for other ED patients.

RESULTS: Median ED LOS for non-admitted patients was 132 minutes (interquartile range (IQR) 83-205.25) for controls and 116 minutes (IQR 75.5-159.0) for cases (p<0.01). Fast-track patients had a significantly higher incidence of discharge within 2 h (53% vs 44%, p<0.01) and 4 h (92% vs 84%, p<0.01).

CONCLUSIONS: ED fast track decreased ED LOS for non-admitted patients without compromising waiting times and ED LOS for other ED patients.