TDNet Discover

Background: In 2020, there were a total of 131.3 million emergency department (ED) visits in the United States. The arising issue is that patients who are triaged as non-urgent often experience long wait times in the ED. Prolonged wait times at the ED are associated with increased morbidity and mortality, as well as decreased patient satisfaction. Purpose: The purpose of this research was to determine how effective having additional providers caring for patients vs. standard ED care is in reducing patient wait times. Methods: An evidence-based clinical review (EBCR) was conducted to address the research question. The literature search and review process included 3 different databases including PubMed, Cochrane Library, and CINAHL Complete. A quality assessment tool from the National Heart, Lung, and Blood Institute (NHLBI) was used to assess the quality of the studies and only included studies that were rated as “fair” quality and above. A data extraction tool was used to organize the data from the included studies. Results: We reviewed 3 studies, 2 systematic reviews and 1 randomized controlled trial, that evaluated over 408,942 patients in EDs across 7 countries. The primary outcome assessed was decreased wait times in the ED. The interventions were grouped into the addition of primary care providers for non-urgent patients in the ED, different methods to improve ED flow and efficiency, and physician-nurse supplementary triage assessment team. While having additional primary care providers for non-urgent patients in the ED was inconclusive, the physician-nurse supplementary triage assessment team was effective in reducing wait times in the ED, as well as fast tracking patients with less severe symptoms. Other methods that were inconclusive in regards to reducing ED wait times were streaming of patients, fast track, team triage, point-ofcare testing, and nurse-requested x-ray. iv Conclusion: Overall, the literature presents evidence that suggests having additional providers in the ED helps to reduce patient wait times. Fast tracking patients with less severe symptoms also was shown to reduce wait times. There were various other interventions in the literature that were inconclusive into regard to their effect on wait times.