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Urgent assessment in emergency departments can reduce surgical decision time and overcrowding
Date:8/8/2011

2,510 patients took part in the study. There were 1,448 patients studied pre-ACCESS and 1,062 studied post-ACCESS implementation. The primary study outcome was surgical decision time; the secondary outcome was a measure of overall ED overcrowding.

In order to better understand the key factors contributing to overcrowding, study authors developed a conceptual model that partitioned ED overcrowding into three interdependent components: input, throughput and output. The input component refers to factors that contribute to the volume of care delivered in the ED. The throughput component refers to factors that contribute to the amount of time a patient spends in the ED. The two main options for output are admission to a hospital bed or discharge. The inability to move patients from the ED to an inpatient bed is considered one of the major contributing factors to ED overcrowding.

Acute care surgery is defined as the urgent assessment and treatment of non-trauma general surgical emergencies (i.e., appendicitis, diverticulitis, bowel obstruction, bilary disease, postoperative complications).


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