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Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department

 Sun Wook Moon  ;  Ji Hwan Lee  ;  Hyun Sim Lee  ;  Ha Yan Kim  ;  Myeongjee Lee  ;  Incheol Park  ;  Hyun Soo Chung  ;  Ji Hoon Kim 
 WESTERN JOURNAL OF EMERGENCY MEDICINE, Vol.23(6) : 846-854, 2022-10 
Journal Title
Issue Date
Critical Illness* / therapy ; Emergency Service, Hospital ; Humans ; Intensive Care Units* ; Length of Stay ; Tertiary Care Centers
Introduction: Critically ill patients are frequently transferred from other hospitals to the emergency departments (ED) of tertiary hospitals. Due to the unforeseen transfer, the ED length of stay (LOS) of the patient is likely to be prolonged in addition to other potentially adverse effects. In this study we sought to confirm whether the establishment of an organized unit - the Emergency Transfer Coordination Center (ETCC) - to systematically coordinate emergency transfers would be effective in reducing the ED LOS of transferred, critically ill patients.

Methods: The present study is a retrospective observational study focusing on patients who were transferred from other hospitals and admitted to the intensive care unit (ICU) of the ED in a tertiary hospital located in northwestern Seoul, the capital city of South Korea, from January 2019 - December 2020. The exposure variable of the study was ETCC approval before transfer, and ED LOS was the primary outcome. We used propensity score matching for comparison between the group with ETCC approval and the control group.

Results: Included in the study were 1,097 patients admitted to the ICU after being transferred from other hospitals, of whom 306 (27.9%) were transferred with ETCC approval. The median ED LOS in the ETCC-approved group was significantly reduced to 277 minutes compared to 385 minutes in the group without ETCC approval. The ETCC had a greater effect on reducing evaluation time than boarding time, which was the same for populations with different clinical features.

Conclusion: An ETCC can be effective in systematically reducing the ED LOS of critically ill patients who are transferred from other hospitals to tertiary hospitals that are experiencing severe crowding.
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1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ji Hoon(김지훈) ORCID logo https://orcid.org/0000-0002-0070-9568
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
Lee, Myeongjee(이명지)
Lee, Ji Hwan(이지환)
Chung, Hyun Soo(정현수) ORCID logo https://orcid.org/0000-0001-6110-1495
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