PMID- 33409055
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210111
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 11
DP  - 2020 Nov 30
TI  - A Multimodal Evaluation of an Emergency Department Electronic Tracking Board 
      Utility Designed to Optimize Stretcher Utilization.
PG  - e11810
LID - 10.7759/cureus.11810 [doi]
LID - e11810
AB  - Objectives The primary objective of this study was to evaluate the impact of an 
      electronic tracking board feature encouraging staff to prompt optimal patient 
      location on total stretcher time (TST) amongst patients moved to a chair in an 
      internal emergency department (ED) waiting room. As a secondary objective, we 
      also sought to identify facilitators and barriers to the tool's use amongst the 
      ED staff. Methods Using an administrative database, a retrospective cohort design 
      was used to compare TST between visits where the tool was used and not used 
      amongst patients relocated from initial assessment space to a chair over an 11.5 
      month period. A mixed-methods design was used to investigate facilitators and 
      barriers to the tool's use amongst the ED staff. Response proportions were used 
      to report Likert scale questions; thematic analysis was used to code themes. 
      Results A total of 56,852 patients met the inclusion criteria and were moved to a 
      chair. The tool was used 4,301 times, with "OK for chairs" selected for 
      3,917/56,852 (6.9%) patients and "not OK for chairs" selected 384/56,852 (0.7%) 
      times. Patient characteristics were similar between both groups. Median 
      interquartile range (IQR) TST amongst patients moved to a chair via the prompt 
      was shorter than when the prompt was not used (148.2 (112.6) mins vs 154.4 
      (115.4) mins, p = 0.005). A total of 125 questionnaires were completed; 95% of 
      staff were aware of the tool and 70% agreed/strongly agreed the tool could 
      improve ED flow. Commonly reported physician barriers to use were forgetting to 
      use the tool; common nursing barriers were lack of chair space and increased 
      workload. Conclusions Despite low function use, prompt use was associated with 
      reduced TST amongst ED patients relocated to a chair.
CI  - Copyright (c) 2020, Chisholm et al.
FAU - Chisholm, Dirk
AU  - Chisholm D
AD  - Department of Medicine, University of Alberta, Edmonton, CAN.
FAU - Wang, Dongmei
AU  - Wang D
AD  - Department of Emergency Medicine, University of Calgary, Calgary, CAN.
FAU - Rich, Thomas A
AU  - Rich TA
AD  - Department of Emergency Medicine, University of Calgary, Calgary, CAN.
FAU - Grabove, Matthew
AU  - Grabove M
AD  - Department of Emergency Medicine, University of Calgary, Calgary, CAN.
FAU - Sherlock, Kelli
AU  - Sherlock K
AD  - Department of Emergency Medicine, University of Calgary, Calgary, CAN.
FAU - Lang, Eddy
AU  - Lang E
AD  - Department of Emergency Medicine, University of Calgary, Calgary, CAN.
LA  - eng
PT  - Journal Article
DEP - 20201130
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7779174
OTO - NOTNLM
OT  - emergency department (ed) overcrowding
OT  - quality improvement
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/01/08 06:00
MHDA- 2021/01/08 06:01
PMCR- 2020/11/30
CRDT- 2021/01/07 06:07
PHST- 2021/01/07 06:07 [entrez]
PHST- 2021/01/08 06:00 [pubmed]
PHST- 2021/01/08 06:01 [medline]
PHST- 2020/11/30 00:00 [pmc-release]
AID - 10.7759/cureus.11810 [doi]
PST - epublish
SO  - Cureus. 2020 Nov 30;12(11):e11810. doi: 10.7759/cureus.11810.