title: Fast Track by physician assistants shortens waiting and turnaround times of trauma patients in an emergency department.
abstract: OBJECTIVE
  We sought to determine whether the introduction of a separate patient flow comprising patients with simple, non-complex health issues [Fast Track (FT)] in a Dutch emergency department setting (ED), without the introduction of additional staff, and treated by a physician assistant, would have favourable effects on waiting and turnaround times without deleterious effects for patients with a higher urgency.
  
  
  METHODS
  We used a prospective comparative intervention design for our study.
  
  
  METHODS
  The waiting times and length of stay for surgical and orthopaedic patients in the ED were measured and compared 3 months before and 3 months after the introduction of FT.
  
  
  RESULTS
  During the study period, 1,289 patients were treated before, and 1,393 after the introduction of FT. After the introduction of FT, we observed a decrease of 12 min (13 %) in the median length of stay for the total group. The median waiting time decreased by 41 min (69 %). The group comprising patients with low to moderate urgency levels showed a median reduction of 12 min in length of stay, whereas the length of stay for urgent patients was reduced by 19 min. The waiting time for the low to moderate urgency patients decreased by 68 min, while the urgent patient group showed a reduction of 32 min.
  
  
  CONCLUSIONS
  The introduction of FT performed by a physician assistant resulted in a significant drop in waiting time and length of stay in a Dutch ED setting. This reduction was realised without the allocation of additional staff and even reduced waiting and turnaround times for the patients with a high urgency.
authors.affiliation: Department of Surgery, Maastricht UMC+, PO Box 5800, P. Debyelaan 25, NL 6202 AZ, Maastricht, The Netherlands. ed.theunissen@mumc.nl.
authors.forename: B H J J
authors.initials: BH
authors.lastname: Theunissen
authors.affiliation: Department of Surgery, Maastricht UMC+, PO Box 5800, P. Debyelaan 25, NL 6202 AZ, Maastricht, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Lardenoye
authors.affiliation: Department of Surgery, Maastricht UMC+, PO Box 5800, P. Debyelaan 25, NL 6202 AZ, Maastricht, The Netherlands.
authors.forename: P H
authors.initials: PH
authors.lastname: Hannemann
authors.affiliation: Department of Surgery, Maastricht UMC+, PO Box 5800, P. Debyelaan 25, NL 6202 AZ, Maastricht, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Gerritsen
authors.affiliation: Department of Surgery, Maastricht UMC+, PO Box 5800, P. Debyelaan 25, NL 6202 AZ, Maastricht, The Netherlands.
authors.forename: P R G
authors.initials: PR
authors.lastname: Brink
authors.affiliation: Department of Surgery, Maastricht UMC+, PO Box 5800, P. Debyelaan 25, NL 6202 AZ, Maastricht, The Netherlands. m.poeze@mumc.nl.
authors.forename: M
authors.initials: M
authors.lastname: Poeze
keywords: Emergency care; Fast-track; Trauma; Waiting time
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