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. 2023 Jul 11;7(7):CD014553.
doi: 10.1002/14651858.CD014553.pub2.

Acute assessment services for patient flow assistance in hospital emergency departments

Victoria Shaw  1 , An Yu  2 , Matthew Parsons  3 , Tava Olsen  4 , Cameron Walker  5
Affiliations

Acute assessment services for patient flow assistance in hospital emergency departments

Victoria Shaw et al. Cochrane Database Syst Rev. .

Abstract
in English, Persian

Background: Emergency departments (EDs) are facing serious and significant issues in the delivery of effective and efficient care to patients. Acute assessment services have been implemented at many hospitals internationally to assist in maintaining patient flow for identified groups of patients attending the ED. Identifying the risks and benefits, and optimal configurations of these services may be beneficial to those wishing to utilise an acute assessment service to improve patient flow.

Objectives: To assess the effects of acute assessment services on patient flow following attendance at a hospital ED.

Search methods: We searched MEDLINE, CENTRAL, Embase and two trials registers on 24 September 2022 to identify studies. No restrictions were imposed on publication year, publication type, or publication language.

Selection criteria: Studies eligible for inclusion were randomised trials and cluster-randomised trials with at least two intervention and two control sites. Participants were adults (as defined by study authors) receiving care either in the ED or the acute assessment service, where both were based in the hospital setting. The comparison was hospital-based acute assessment services with usual, ED-only care. The outcomes of this review were mortality at time point closest to 30 days, length of stay in the service (in minutes), and waiting time to see a doctor (in minutes).

Data collection and analysis: We followed the standard procedures of Cochrane Effective Practice and Organisation of Care for this review (https://epoc.cochrane.org/resources).

Main results: We identified a total of 5754 records in the search. Following assessment of 3609 de-duplicated records, none were found to be eligible for inclusion in this review.

Authors' conclusions: At present there are no randomised controlled trials exploring the effects of acute assessment services on patient flow in hospital-based emergency departments compared to usual, ED-only care.

پیشینه: بخش‌های اورژانس (emergency departments; EDs) با مسائل جدی و قابل‌توجهی در ارائه مراقبت‌های موثر و کارآمد به بیماران مواجه هستند. خدمات ارزیابی حاد (acute assessment services) در بسیاری از بیمارستان‌ها در سطح بین‌المللی به منظور کمک به حفظ جریان بیمار (patient flow) برای گروه‌های مشخص شده از بیمارانی که در ED شرکت می‌کنند، به مرحله اجرا درآمده‌اند. شناسایی خطرات و مزایا، و پیکربندی مطلوب این خدمات ممکن است برای کسانی که مایل به استفاده از خدمات ارزیابی حاد برای بهبود جریان بیمار هستند، مفید باشند. اهداف: ارزیابی اثرات خدمات ارزیابی حاد بر جریان بیمار پس از حضور در ED بیمارستان. روش‌های جست‌وجو: برای شناسایی مطالعات، MEDLINE؛ CENTRAL؛ Embase و دو پایگاه ثبت کارآزمایی را در 24 سپتامبر 2022 جست‌وجو کردیم. هیچ محدودیتی برای سال انتشار، نوع انتشار یا زبان انتشار مطالعات اعمال نشد. معیارهای انتخاب: مطالعات واجد شرایط برای ورود، کارآزمایی‌های تصادفی‌سازی‌شده و خوشه‌ای‐تصادفی‌سازی شده با حداقل دو محل مداخله و دو محل کنترل بودند. شرکت‌کنندگان، بزرگسالی بودند (مطابق با تعریف نویسندگان مطالعه) که در ED یا خدمات ارزیابی حاد، مراقبت دریافت کردند، که هر دو در محیط بیمارستانی انجام شدند. مقایسه عبارت بود از خدمات ارزیابی حاد بیمارستان‐محور با فقط مراقبت معمول و ED. نتایج این مرور شامل مورتالیتی در کوتاه‌ترین نقطه زمانی تا 30 روز، طول دوره بستری در مرکز ارائه خدمت (بر حسب دقیقه)، و زمان انتظار برای ملاقات با پزشک (در دقیقه). گردآوری و تجزیه‌وتحلیل داده‌ها: پروسیجرهای استاندارد گروه عملکرد موثر و سازمان‌‌دهی مراقبت در کاکرین را برای این مرور دنبال کردیم (https://epoc.cochrane.org/resources). نتایج اصلی: در مجموع 5754 رکورد را در جست‌وجوی خود شناسایی کردیم. پس از ارزیابی 3609 رکورد حذف شده، هیچ یک واجد شرایط برای گنجاندن در این مرور نبودند. نتیجه‌گیری‌های نویسندگان: در حال حاضر هیچ کارآزمایی تصادفی‌سازی شده و کنترل شده‌ای وجود ندارد که اثرات خدمات ارزیابی حاد را بر جریان بیمار در بخش‌های اورژانس بیمارستانی در مقایسه با فقط مراقبت‌های معمول ED بررسی کرده باشد.

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Conflict of interest statement

Victoria M Shaw: none known

An Yu: none known

Matthew Parsons: none known

Tava L Olsen: none known

Cameron G Walker: none known

Figures

1
1
Study flow diagram.
See this image and copyright information in PMC

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  • doi: 10.1002/14651858.CD014553

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