Evaluation of Fast Track.

This paper is the second of two articles discussing the execution and evaluation of implementing a Fast Track program in a West Australian outer metropolitan hospital Emergency Department. The first paper in the series outlined the implementation process over a 12-month period. This current paper presents the findings of the 12-month evaluation utilising Statistical Process Charts. The object of this evaluation was to undertake analysis of data throughout the change process and demonstrate the effectiveness of implementing Fast Track into the Department. Following the implementation of Fast Track, the Department's "Did not wait" rate decreased over a 12-month period from 10% to 5.4%, without a detrimental impact on treatment times for the patients with serious illnesses and injuries. Furthermore, Fast Track resulted in patients with minor injuries or illnesses being seen, treated and discharged within 2 hours of presentation. Indeed the journey time decreased for all Emergency Department patients. As a result of Fast Track, the Emergency Department waiting area is less congested and staff moral has increased. A further consequence of Fast Track is that nurses are providing more advanced clinical services to patients.

[1]  M. Weissberg,et al.  Patients who leave without being seen. , 1986, Annals of emergency medicine.

[2]  B. Nelson,et al.  Faculty triage shortens emergency department length of stay. , 2001, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[3]  P. Cameron,et al.  A paradigm shift in the nature of care provision in emergency departments , 2004, Emergency Medicine Journal.

[4]  A. Weaver,et al.  The left-without-being-seen patients: what would keep them from leaving? , 2003, Annals of emergency medicine.

[5]  R H Brook,et al.  Patients who leave a public hospital emergency department without being seen by a physician. Causes and consequences. , 1991, JAMA.

[6]  S Saint Lamont,et al.  "See and Treat": spreading like wildfire? A qualitative study into factors affecting its introduction and spread , 2005, Emergency Medicine Journal.

[7]  J. Christenson,et al.  Does reduced length of stay decrease the number of emergency department patients who leave without seeing a physician? , 1997, The Journal of emergency medicine.

[8]  Margaret Fry,et al.  Patients regularly leave emergency departments before medical assessment: A study of did not wait patients, medical profile and outcome characteristics , 2004 .

[9]  M. Cooke,et al.  The effect of a separate stream for minor injuries on accident and emergency department waiting times , 2002, Emergency medicine journal : EMJ.

[10]  Nicola J. Ross,et al.  Evaluation of a 'See and Treat' pilot study introduced to an emergency department. , 2004, Accident and emergency nursing.

[11]  R A Dershewitz,et al.  Patients who leave a pediatric emergency department without treatment. , 1986, Annals of emergency medicine.

[12]  D. Kyriacou,et al.  A 5-year time study analysis of emergency department patient care efficiency. , 1999, Annals of emergency medicine.

[13]  D W Baker,et al.  Patients who leave emergency departments without being seen by a physician: magnitude of the problem in Los Angeles County. , 1994, Annals of emergency medicine.