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Effects of a short text message reminder system on emergency department length of stay.

Authors
 Min Joung Kim  ;  Joon Min Park  ;  Sang Mo Je  ;  Je Sung You  ;  Yoo Seok Park  ;  Hyun Soo Chung  ;  Sung Phil Chung  ;  Hahn Shick Lee 
Citation
 INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS, Vol.81(5) : 296-302, 2012 
Journal Title
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
ISSN
 1386-5056 
Issue Date
2012
MeSH
Adolescent ; Adult ; Child ; Child, Preschool ; Emergency Service, Hospital* ; Female ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Length of Stay/statistics & numerical data* ; Male ; Outcome Assessment (Health Care)* ; Patient Admission ; Referral and Consultation* ; Reminder Systems* ; Text Messaging* ; Time Factors ; Young Adult
Keywords
Consultation ; Length of stay ; Emergency department
Abstract
PURPOSE: Specialty consultations and waiting for admission to a hospital bed are major contributors to increased length of stay and overcrowding in the emergency department. We implemented a computerized short messaging service to inform care providers of patient delay in order to reduce length of stay. The purpose of this study was to evaluate the effects of this strategy on length of stay in the emergency department.

METHODS: This was a before-and-after observational study. Prior to this study, we registered the mobile phone numbers of all board certified specialists into a computerized physician order entry database and developed an auto-sending short messaging program linked to consultation orders. The short message was transmitted at 2 and 4h after consultation, when a disposition was not yet established, and at 8h after the admission order if the patient was still waiting. The length of stay of consulted patients and intervals such as consultation time (registration-consultation), disposition time (consultation-admission decision), and boarding time (admission decision-hospitalization) of admitted patients were compared between the pre-implementation (September 2009) and post-implementation period (November 2009). Subgroup analyses of disposition time were performed according to time of consultation and the number of consultations.

RESULTS: A total of 7518 patients visited the emergency department during the pre-periods and post-periods. Among them, 3335 patients required specialty consultations. The median length of stay of consulted patients decreased significantly after implementation of the messaging system (pre-207 min vs. post-193 min, p<0.001). Among admitted patients, the median length of stay decreased by 36 min from 294 min to 258 min (p<0.001). In the subgroup analysis, times for establishing patient dispositions decreased significantly when the consultation was performed at night and when there was only one department consulted. The numbers of patients with disposition times within 2 and 4h and boarding times within 8h were all increased after implementation of the short message service program.

CONCLUSIONS: This study suggested that the computerized physician order entry-based short messaging service program, used to inform decision-makers of patient delay, could reduce the length of stay for consulted patients in the emergency department.
Full Text
http://www.sciencedirect.com/science/article/pii/S1386505612000020
DOI
22300639
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hahn Shick(이한식)
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90491
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