Is the fast-track process efficient and safe for older adults admitted to the emergency department?

BMC Geriatr. 2020 Apr 28;20(1):154. doi: 10.1186/s12877-020-01536-5.

Abstract

Background: The efficiency of the fast-track (FT) process in the management of patients in Emergency Departments is well demonstrated, but there is a lack of research focused on older adults. The aim of our study was to verify whether the FT process is efficient and safe for older adults admitted to ED.

Methods: Observational case-control single-centre study.

Results: Five hundred four cases and 504 controls were analysed. The mean age was 75 years, and there was a predominance of women. In total 96% of subjects were classified with a "less-urgent" tag. The length of stay was significantly lower in the fast-track group than in the control group (median 178 min, interquartile range 184 min, and 115 min, interquartile range 69 min, respectively, p < 0.001), as well as the time spent between the ED physician's visit and patient discharge (median 78 min, interquartile range 120 min, and median 3 min, interquartile range 6 min, respectively, p < 0.001). There weren't any increases in the number of unplanned readmissions within 48 h, 7 days and 30 days.

Conclusions: The fast-track appears to be an efficient and safe strategy to improve the management of older adults admitted to the ED with minor complaints.

Keywords: Emergency department; Fast-track; Length of stay; Older adults.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Appointments and Schedules
  • Case-Control Studies
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Patient Discharge
  • Quality of Health Care*
  • Triage / methods*