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- Title
Analysis and impact of delays in ambulance to emergency department handovers.
- Authors
Cone, David C; Middleton, Paul M; Marashi Pour, Sadaf
- Abstract
Objectives Delays in the clinical handover of patient care from emergency medical services ( EMS) to the ED because of ED crowding are a substantial problem for many EMS systems. This study was conducted to quantify handover delays experienced by the Ambulance Service of New South Wales ( ASNSW), and to investigate patient and system factors associated with handover delay. Methods A retrospective study of EMS dispatch and ambulance patient care records was conducted for all patients transported by ASNSW in January/ April/ July/ October 2009. Patient characteristics and time intervals were summarised using descriptive statistics, with handover delay categorised as <30 min, 30-60 min and ≥60 min. Times are reported as HH: MM: SS. Partial proportional odds models were used to investigate factors associated with delays. Results Of 141 381 transports, 12.5% of patients experienced a handover delay of 30-60 min, and 5% a delay of ≥60 min. The median handover interval was 00:15:46 ( IQR 00:08:58-00:24:52, maximum 08:43:13). Patients transported to large hospitals were more likely to experience a delay of ≥30 min (odds ratio [ OR] 14.57, 95% CI 11.41-18.60) or ≥60 min ( OR 15.75, 95% CI 12.27-20.23) than those transported to small hospitals. Patients in major cities were more likely to experience delays than those in other areas, and patients ≥65 years were more likely to experience delays than those <16 years. Delays were most likely in winter. Cardiac and major trauma patients had the lowest likelihood of experiencing delays. Conclusions Handover delays are relatively common at the EMS/ ED interface in New South Wales, and are most pronounced at large hospitals, in urban areas and during winter.
- Subjects
NEW South Wales; CONFIDENCE intervals; EPIDEMIOLOGY; MULTIVARIATE analysis; SCIENTIFIC observation; REGRESSION analysis; RESEARCH funding; STATISTICS; WORK measurement; DATA analysis; RETROSPECTIVE studies; TRANSPORTATION of patients; DATA analysis software; DESCRIPTIVE statistics; TREATMENT delay (Medicine)
- Publication
Emergency Medicine Australasia, 2012, Vol 24, Issue 5, p525
- ISSN
1742-6731
- Publication type
Article
- DOI
10.1111/j.1742-6723.2012.01589.x