Yeak Daryl, Osman Abdi D, MacGibbon Paul, Van Der End Amy, Mansouri Negar, Matarazzo Michelle, Braitberg George
Emergency Department, Austin Health, Heidelberg, Melbourne, Victoria, Australia.
College of Sports, Health and Engineering, Victoria University, St Albans, Melbourne, Victoria, Australia.
Emerg Med Australas. 2025 Jun;37(3):e70083. doi: 10.1111/1742-6723.70083.
Patients who frequently present to the Emergency Department (ED) often have complex care needs, requiring substantial resources and resulting in longer stays. Emergency Care Management Plans (ECMPs) are designed to help clinicians adopt a person-centred approach, clarify goals, avoid unnecessary interventions, and reduce ED visit frequency and duration. ECMPs at our institution were previously stored in paper medical records, making timely access difficult. On April 2, 2012, ECMPs were scanned into the Electronic Medical Record (EMR), allowing easier access. This study assesses the impact of electronic ECMPs.
Using a retrospective observational design guided by the STROBE checklist, we evaluated whether the introduction of electronic ECMPs reduced the frequency and duration of ED visits. Data from all ED patients with electronic ECMPs were extracted and analysed to compare variables pre- and post-implementation, including demographics, most common triage data, visit frequency, length of stay (LOS), and discharge diagnoses.
A total of 115 patients (mean age: 53) were included. Ambulance transport was the most common (64%), and Australasian Triage Scale (ATS) category 3 was the most frequent (57%). Post implementation the mean number of presentations reduced from 16 to 9, and ED LOS (EDLOS) decreased from 4676 to 2577 min (p < 0.001). Short Stay Unit LOS (SSULOS) decreased from 1359 to 638 min (p < 0.001), leading to an overall reduction of 2802 min (p < 0.001).
ECMPs effectively reduced both the frequency and duration of ED visits. Further research is needed to explore patient experience and other outcome measures.
经常前往急诊科（ED）就诊的患者通常有复杂的护理需求，需要大量资源，导致住院时间延长。急诊护理管理计划（ECMPs）旨在帮助临床医生采用以患者为中心的方法，明确目标，避免不必要的干预，并减少急诊科就诊频率和时长。我们机构的急诊护理管理计划以前存储在纸质病历中，难以及时获取。2012年4月2日，急诊护理管理计划被扫描到电子病历（EMR）中，便于更轻松地获取。本研究评估了电子急诊护理管理计划的影响。
采用由STROBE清单指导的回顾性观察设计，我们评估了引入电子急诊护理管理计划是否降低了急诊科就诊的频率和时长。提取并分析了所有有电子急诊护理管理计划的急诊科患者的数据，以比较实施前后的变量，包括人口统计学、最常见的分诊数据、就诊频率、住院时长（LOS）和出院诊断。
共纳入115名患者（平均年龄：53岁）。救护车运送是最常见的方式（64%），澳大利亚分诊量表（ATS）3级是最常见的级别（57%）。实施后，就诊的平均次数从16次减少到9次，急诊科住院时长（EDLOS）从4676分钟降至2577分钟（p < 0.001）。短期住院病房住院时长（SSULOS）从1359分钟降至638分钟（p < 0.001），总体减少了2802分钟（p < 0.001）。
急诊护理管理计划有效降低了急诊科就诊的频率和时长。需要进一步研究以探索患者体验和其他结果指标。
