Evaluating the quality of care delivered by an emergency department fast track unit with both nurse practitioners and doctors

Abstract

Aims: This paper is a report of a study of quality of care delivered by an emergency department fast track unit where both doctors and an emergency nurse practitioner treated patients.

Background: Fast track units were established in Australian emergency departments to meet the needs of low complexity emergency department patients. Few studies have reported on the overall quality of care delivered by these units.

Methods: A convenience sample of adult patients triaged to an Australian emergency department fast track unit between April 2010 and April 2011 were randomised to care by a doctor or an emergency nurse practitioner. Quality of care was measured using patient satisfaction, follow up health status using Short Form 12 and adverse event rate (missed fractures or unplanned representations).

Results: A total of 320 patients were enrolled into the study. Of the 236 patients who submitted completed survey forms, median satisfaction scores were 22 out of 25 with 84% of patients rating care as "excellent" or "very good". At two week follow up, health status score was comparable to normal healthy populations. When comparing study groups, patient satisfaction scores were significantly higher in the ENP group compared to DR group.

Conclusions: Patients received high quality of care in this fast track unit where both nurse practitioner and doctors treated patients. Emergency nurse practitioners were associated with higher patient satisfaction.