title: A summative evaluation of an EMS partnership aimed at reducing ED length of stay.
abstract: BACKGROUND
  Freestanding emergency departments are full-service emergency departments with no attached inpatient facility. ED congestion and patient dissatisfaction may occur as patients requiring admission are waiting for ambulance arrival and transfer. A partnership between a freestanding emergency department and a private ambulance company was developed in order to reduce ambulance response times and ultimately ED length of stay. The aim of this manuscript was to describe the Partnership in Care program and evaluate the program's effectiveness.
  
  
  METHODS
  The study used a pre-post/post-test summative evaluation design. A retrospective chart review was done for all patients discharged from the freestanding emergency department by the partnered ambulance company during the pre-test period, April 2004 to June 2004, and the post-test period, April 2005 to June 2005. Data variables included time of triage, time ambulance requested, time ambulance arrived, and discharge time. Institutional Review Board approval was obtained.
  
  
  RESULTS
  There were 507 patients transported at discharge by the ambulance company. There was a 5-minute increase for mean ED length of stay although not significant. Mean ambulance response time was significantly reduced by 8 minutes.
  
  
  CONCLUSIONS
  The program did not achieve the primary goal of reducing ED length of stay, however the private EMS workers provided countless hours of patient care to the freestanding ED patients without charge to the freestanding emergency department for the EMS providers' time.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. gillesgl@yahoo.com
authors.forename: Gordon Lee
authors.initials: GL
authors.lastname: Gillespie
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Yap
authors.forename: Marilyn
authors.initials: M
authors.lastname: Singleton
authors.forename: Mark
authors.initials: M
authors.lastname: Elam
mesh_terms: D000552:Ambulances / Q000458:organization & administration; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D003299:Cooperative Behavior; D003441:Crowding; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians / Q000458:organization & administration*; D016529:Emergency Nursing / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D007902:Length of Stay / Q000706:statistics & numerical data*; D015403:Nursing Evaluation Research; D009820:Ohio; D010360:Patient Transfer / Q000458:organization & administration; D024382:Professional Role; D015397:Program Evaluation; D012189:Retrospective Studies; D013997:Time Factors; D014187:Transportation of Patients / Q000458:organization & administration; D014218:Triage