Key result
The fast-track process significantly reduced the median emergency department length of stay for older adults from 178 minutes to 115 minutes compared to usual care.
Why the study?
The efficiency of the fast-track process in emergency departments is well demonstrated, but research focused on older adults is lacking.
Does a fast-track process reduce emergency department length of stay and maintain safety in older adults with minor complaints?
Case-Control (n=1,008)
No
Does a fast-track process reduce emergency department length of stay and maintain safety in older adults with minor complaints?
Absolute Event Rate: 115% vs 178%
p-value: p=<0.001
A fast-track process in the emergency department significantly reduces length of stay for older adults with minor complaints without increasing unplanned readmissions.
Fast-track may shorten ED stays for older adults with minor complaints; leaves open randomized confirmation of safety and generalizability.
BACKGROUND: The efficiency of the fast-track (FT) process in the management of patients in Emergency Departments is well demonstrated, but there is a lack of research focused on older adults. The aim of our study was to verify whether the FT process is efficient and safe for older adults admitted to ED. METHODS: Observational case-control single-centre study. RESULTS: Five hundred four cases and 504 controls were analysed. The mean age was 75 years, and there was a predominance of women. In total 96% of subjects were classified with a "less-urgent" tag. The length of stay was significantly lower in the fast-track group than in the control group (median 178 min, interquartile range 184 min, and 115 min, interquartile range 69 min, respectively, p < 0.001), as well as the time spent between the ED physician's visit and patient discharge (median 78 min, interquartile range 120 min, and median 3 min, interquartile range 6 min, respectively, p < 0.001). There weren't any increases in the number of unplanned readmissions within 48 h, 7 days and 30 days. CONCLUSIONS: The fast-track appears to be an efficient and safe strategy to improve the management of older adults admitted to the ED with minor complaints.
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Gasperini et al. (2020) conducted a case-control in Non-urgent emergency department visits (n=1,008). Fast-track process vs. Usual process was evaluated on Emergency department length of stay (minutes) (p=<0.001). The fast-track process significantly reduced the median emergency department length of stay for older adults from 178 minutes to 115 minutes compared to usual care.
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