Anecdotally, the narrow variation has impacted positively, leading to a reduction in the number of patient complaints. Unlike most other studies which required additional staffing resources, we achieved our goal by realignment of staff. Other unique features of the fast track area is that it was culturally sensitive (Arabic speaking doctors) and operated on a continuous 24 hour

cycle. We did not examine a rapid entry and accelerated care at triage unlike a recent large trial which altered processes and revised their health informatics technology [27]. This study has also demonstrated that the opening of a FTA had no detrimental impact on the WTs and LOS of patients with serious injuries and illnesses. Both the Inhibitors,research,lifescience,medical mean WTs of CTAS 2 and CTAS 3 patients decreased (Table ​(Table2).2). LOS also decreased in the post-intervention CTAS 2 group. These improvements were unexpected because the FTA is designed to expedite the care of non-urgent patients only. This improvement may have occurred for a number of reasons. Firstly, Inhibitors,research,lifescience,medical since the FTA reduced www.selleckchem.com/products/qnz-evp4593.html overcrowding in the ED waiting room by diverting non-urgent patients to a separate treatment area, it may have given staff more physical space as well as a less distracting environment to focus their activities. Secondly, the frenetic environment of the overcrowded ED has a negative effect on physician productivity. At a certain limit of patients, productivity

declines and patient care is compromised [1]. Presumably, Inhibitors,research,lifescience,medical a decrease in overcrowding may have improved physician productivity. One method to mitigate the impact of low acuity patients on ED overcrowding is to triage them to care elsewhere (walk-in clinics, same-day or next-day visits with a primary care provider, etc). However, Inhibitors,research,lifescience,medical it is both medically unsafe and financially Inhibitors,research,lifescience,medical unnecessary to create barriers to ED care for low-acuity patients. It is more appropriate to identify the needs of this subset of patients and to subsequently tailor the delivery of resources to

meet these needs. As noted by the Institute for Healthcare Improvement, strategies that reduce operational cycle times and improve patient flow are critical to accomplish this [28]. This is the basis for the development of a FTA for low-acuity patients that many hospitals have initiated. Limitations Randomization of ED patients with acute medical problems is difficult due to the ethical constraints and administrative constraints in such patients. Amisulpride Similar to our study looking at ED FTAs, the predominant research design of prior studies was quasi-experimental. We attempted to remove threats to the internal validity of our study, which is the main limitation of this design [29-31]. Firstly, the sample size of this study was large (n = 10,485) in relation to previous studies [16-18]. The large sample size mitigated against the outcomes being attributed to regression to the mean. Secondly, there were many outcomes that varied statistically with the intervention [29,32].