@2024 Afarand., IRAN
ISSN: 2383-3483 Journal of Police Medicine 2019;8(2):87-92
ISSN: 2383-3483 Journal of Police Medicine 2019;8(2):87-92
One-Year Analysis of the Emergency Department Input and Output; a Case Study of Sina Hospital, Iran
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Talebpour M. (1)Payandemehr P. (2)
Kalhor P. (3)
Abbasi N. (4)
Baratloo (*)
(*) Pre-Hospital and Hospital Research Center” and “Department of Emergency Medicine, School of Medicine”, Tehran University of Medical Sciences, Tehran, Iran
(1) Department of Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
(2) Pre-Hospital and Hospital Research Center” and “Department of Emergency Medicine, School of Medicine", Tehran University of Medical Sciences, Tehran, Iran
(3) School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
(4) Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Correspondence
Address: Department of Emergency Medicine, Tehran University of Medical Sciences, Poor Sina Street, Tehran, IranPhone: +98 (21) 63121432
Fax: +98 (21) 63121432
arbaratloo@sina.tums.ac.ir
Article History
Received: December 8, 2018Accepted: January 20, 2019
ePublished: March 19, 2019
ABSTRACT
Aims
The aim of this study was to analyze the input and output patterns of patients in the emergency department (ED) of Sina Hospital in 2017.
Instrument & Methods This cross sectional study was carried out, retrospectively, in Sina Hospital affiliated to Tehran University of Medical Sciences. All patients referring to the ED during 2017 entered the study. At first, the inputs were checked to determine in which paths the patients were referred to the ED. Then, the outcomes of the patients were checked to determine how much of the ED entrance were discharged, hospitalized, dispatched, or possibly died.
Findings In 2017, a total of 34901 patients were referred to the ED at Sina Hospital, of whom 27.8% were referred with pre-hospital emergency medicine service, 1.7% were sent from other centers, and 70.5% were referred to the ED as outpatients. Of them, 78.48% were discharged from the ED after taking appropriate action from the emergency medicine specialist. Out of 21.52% of other outcomes, 0.33% died at the time of entry, 4.44% died after arrival, 1.2% were referred to other centers, 19.51% were transferred from emergency department to hospital, and 42.1% were discharged with personal satisfaction.
Conclusion Outpatient referral is the most common way for patients to enter the ED, and about 80% of patients referring to the ED are visited and discharged by the emergency department.
Instrument & Methods This cross sectional study was carried out, retrospectively, in Sina Hospital affiliated to Tehran University of Medical Sciences. All patients referring to the ED during 2017 entered the study. At first, the inputs were checked to determine in which paths the patients were referred to the ED. Then, the outcomes of the patients were checked to determine how much of the ED entrance were discharged, hospitalized, dispatched, or possibly died.
Findings In 2017, a total of 34901 patients were referred to the ED at Sina Hospital, of whom 27.8% were referred with pre-hospital emergency medicine service, 1.7% were sent from other centers, and 70.5% were referred to the ED as outpatients. Of them, 78.48% were discharged from the ED after taking appropriate action from the emergency medicine specialist. Out of 21.52% of other outcomes, 0.33% died at the time of entry, 4.44% died after arrival, 1.2% were referred to other centers, 19.51% were transferred from emergency department to hospital, and 42.1% were discharged with personal satisfaction.
Conclusion Outpatient referral is the most common way for patients to enter the ED, and about 80% of patients referring to the ED are visited and discharged by the emergency department.
CITATION LINKS
[1]Isken MW, Rajagopalan B. Data mining to support simulation modeling of patient flow in hospitals. J Med Syst. 2002;26(2):179-97.
[2]Haroutunian P, Alsabri M, Kerdiles FJ, Hassan AA, Bellou A. Analysis of factors and medical errors involved in patient complaints in a european emergency department. Adv J Emerg Med. 2018;2(1):e4.
[3]Mirbaha S, Forouzanfar M, Mohebi M, Kariman H. The cost of leaving the emergency department without notice: A cross-sectional study. Adv J Emerg Med. 2018;2(1):e6.
[4]van Sambeek JR, Cornelissen FA, Bakker PJ, Krabbendam JJ. Models as instruments for optimizing hospital processes: A systematic review. Int J Health Care Qual Assur. 2010;23(4):356-77.
[5]Majidi A, Mahmoodi S, Adineh VH. An epidemiologic study of emergency department visits before and after executing health sector evolution plan: A brief report. Iran J Emerg Med. 2017;4(3):130-4. [Persian]
[6]Hashemi B, Baratloo A, Forouzafar MM, Motamedi M, Tarkhorani M. Patient satisfaction before and after executing health sector evolution plan. Iran J Emerg Med. 2015;2(3):127-33. [Persian]
[7]Asplin BR, Magid DJ, Rhodes KV, Solberg LI, Lurie N, Camargo CA, Jr. A conceptual model of emergency department crowding. Ann Emerg Med. 2003;42(2):173-80.
[8]Centeno M, Giachetti R, Linn R, Ismail A. A simulation-ilp based tool for scheduling ER staff. Proceedings of the 2003 Winter Simulation Conference. New Orleans, LA: IEEE; 2003. pp. 1930-8.
[9]Hall R, editor. Patient flow: Reducing delay in healthcare delivery. New York: Elsevier; 2007.
[10]McCaig LF, Burt CW. National hospital ambulatory medical care survey: 1999 emergency department summary. Adv Data. 2001;25(320):1-34.
[11]Dolatabadi AA, Maleki M, Memary E, Kariman H, Shojaee M, Baratloo A. The use of emergency department services for non-emergency conditions. Health Med. 2017;11(1):3-9.
[12]Christopher G. Reducing Patient Flow to help America's emergency departments. Urgent Matters. 2004.
[13]Bazzoli GJ, Brewster LR, Liu G, Kuo S. Does US hospital capacity need to be expanded?. Health Aff. 2003;22(6):40-54.
[14]Derlet R, Richards J, Kravitz R. Frequent overcrowding in US emergency departments. Acad Emerg Med. 2001;8(2):151-5.
[15]Fletcher A, Halsall D, Huxham S, Worthington D. The DH accident and emergency department model: A national generic model used locally. J Oper Res Soc. 2007;58(12):1554-62.
[16]Fletcher A, Worthington D. What is a generic hospital model?—a comparison of generic and specific hospital models of emergency patient flows. Health Care Manag Sci. 2009;12(4):374-91.
[17]Konnyu H, Turner L, Skidmore B, Daniel R, Forster A, Mohan D. What input and output variables have been used in models of patient flow in acute care hospital settings? Evidence Summary No 12 developed as part of the ohri-champlainlhin knowledge to action research program June 2011.
[18] Dent AW, Phillips GA, Chenhall AJ, McGregor LR. The heaviest repeat users of an inner city emergency department are not general practice patients. Emerg Med. 2003;15(4):322-9.
[19]Momeni M, Vahidi E, Seyedhosseini J, Jarchi A, Naderpour Z, Saeedi M. Emergency overcrowding impact on the quality of care of patients presenting with acute stroke. Adv J Emerg Med. 2018;2(1):e3.
[20]Warden CR, Bangs C, Norton R, Huie J. Temporal trends in ambulance diversion in a mid-sized metropolitan area. Prehosp Emerg Care. 2003;7(1):109-13.
[21]Safari S, Rahmati F, Baratloo A, Motamedi M, Forouzanfar MM, Hashemi B, et al. Hospital and pre-hospital triage systems in disaster and normal conditions: A review article. Iran J Emerg Med. 2015;2(1):2-10.
[22]Derlet RW. Triage and ED overcrowding: Two cases of unexpected outcome. Cal J Emerg Med. 2002;3(1):8.
[2]Haroutunian P, Alsabri M, Kerdiles FJ, Hassan AA, Bellou A. Analysis of factors and medical errors involved in patient complaints in a european emergency department. Adv J Emerg Med. 2018;2(1):e4.
[3]Mirbaha S, Forouzanfar M, Mohebi M, Kariman H. The cost of leaving the emergency department without notice: A cross-sectional study. Adv J Emerg Med. 2018;2(1):e6.
[4]van Sambeek JR, Cornelissen FA, Bakker PJ, Krabbendam JJ. Models as instruments for optimizing hospital processes: A systematic review. Int J Health Care Qual Assur. 2010;23(4):356-77.
[5]Majidi A, Mahmoodi S, Adineh VH. An epidemiologic study of emergency department visits before and after executing health sector evolution plan: A brief report. Iran J Emerg Med. 2017;4(3):130-4. [Persian]
[6]Hashemi B, Baratloo A, Forouzafar MM, Motamedi M, Tarkhorani M. Patient satisfaction before and after executing health sector evolution plan. Iran J Emerg Med. 2015;2(3):127-33. [Persian]
[7]Asplin BR, Magid DJ, Rhodes KV, Solberg LI, Lurie N, Camargo CA, Jr. A conceptual model of emergency department crowding. Ann Emerg Med. 2003;42(2):173-80.
[8]Centeno M, Giachetti R, Linn R, Ismail A. A simulation-ilp based tool for scheduling ER staff. Proceedings of the 2003 Winter Simulation Conference. New Orleans, LA: IEEE; 2003. pp. 1930-8.
[9]Hall R, editor. Patient flow: Reducing delay in healthcare delivery. New York: Elsevier; 2007.
[10]McCaig LF, Burt CW. National hospital ambulatory medical care survey: 1999 emergency department summary. Adv Data. 2001;25(320):1-34.
[11]Dolatabadi AA, Maleki M, Memary E, Kariman H, Shojaee M, Baratloo A. The use of emergency department services for non-emergency conditions. Health Med. 2017;11(1):3-9.
[12]Christopher G. Reducing Patient Flow to help America's emergency departments. Urgent Matters. 2004.
[13]Bazzoli GJ, Brewster LR, Liu G, Kuo S. Does US hospital capacity need to be expanded?. Health Aff. 2003;22(6):40-54.
[14]Derlet R, Richards J, Kravitz R. Frequent overcrowding in US emergency departments. Acad Emerg Med. 2001;8(2):151-5.
[15]Fletcher A, Halsall D, Huxham S, Worthington D. The DH accident and emergency department model: A national generic model used locally. J Oper Res Soc. 2007;58(12):1554-62.
[16]Fletcher A, Worthington D. What is a generic hospital model?—a comparison of generic and specific hospital models of emergency patient flows. Health Care Manag Sci. 2009;12(4):374-91.
[17]Konnyu H, Turner L, Skidmore B, Daniel R, Forster A, Mohan D. What input and output variables have been used in models of patient flow in acute care hospital settings? Evidence Summary No 12 developed as part of the ohri-champlainlhin knowledge to action research program June 2011.
[18] Dent AW, Phillips GA, Chenhall AJ, McGregor LR. The heaviest repeat users of an inner city emergency department are not general practice patients. Emerg Med. 2003;15(4):322-9.
[19]Momeni M, Vahidi E, Seyedhosseini J, Jarchi A, Naderpour Z, Saeedi M. Emergency overcrowding impact on the quality of care of patients presenting with acute stroke. Adv J Emerg Med. 2018;2(1):e3.
[20]Warden CR, Bangs C, Norton R, Huie J. Temporal trends in ambulance diversion in a mid-sized metropolitan area. Prehosp Emerg Care. 2003;7(1):109-13.
[21]Safari S, Rahmati F, Baratloo A, Motamedi M, Forouzanfar MM, Hashemi B, et al. Hospital and pre-hospital triage systems in disaster and normal conditions: A review article. Iran J Emerg Med. 2015;2(1):2-10.
[22]Derlet RW. Triage and ED overcrowding: Two cases of unexpected outcome. Cal J Emerg Med. 2002;3(1):8.