응급실 협진의뢰의 자동화가 응급실 체류시간에 미치는 영향 (Effect of Emergency Auto-Consultation System (EACS) on Length of Stay of Specialty Consultation Patients in the Emergency Department)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 20권 / 2호 / 155 ~ 162페이지
· 저자명 : 김원희, 강형구, 최혁중, 임태호, 강보승

초록

Purpose: The length of stay (LOS) for patients in the emergency
department (ED) provides an important measure of
both ED overcrowding and patient satisfaction. Specialty
consultation is one of the major factors that contributes to
longer LOS. The aim of the study was to examine the effectiveness
of a computer-based emergency auto-consultation
system (EACS) in reducing additional LOS caused by specialty
consultation.
Methods: The EACS was developed for use in managing
specialty consultation in the ED. Each clinical department
provides a daily list of 4 residents and 1 specialist as the
doctors on duty. The ED doctors then use the EACS to
contact the departments required for a specialty consultation:
Clicking the department’s name on the computer
screen activates the short message service (SMS) calling
system, which sends a message with the registration numbers
and names of the relevant patients every 10 min to the
mobile phones of individuals assigned as doctors on duty,
in the order listed. The doctors who receive the SMS are
asked to arrive at the ED within 10 minutes. If the the firstlisted
doctors on duty do not show up in 10 minutes, an
SMS is sent to the next group of doctors on duty on the list.
In 50 minutes, therefore, 5 groups of doctors on duty will
have received the SMS in the order listed.
Each clinical department estimated the response time of
doctors on duty 2 months before the adoption of the EACS
versus afterward. The LOS of patients admitted to the ED
was also compared before and after the adoption of the
EACS. A questionnaire was used to survey the health professionals
working in the ED about the changes in the
intensity of labor and the needs of the EACS.
Results: The number of patients participating in the study
were 2,035 and 2,216, respectively, before and after the
adoption of the EACS. The EACS significantly decreased
both the response time of doctors on duty (34.8±35.5 min
vs. 9.7±16.8 min, p=0.000) and the LOS (155.3±126.7
min vs. 144.6±110.7 min, p=0.003). In the survey, 44.7%
of ED health care professionals responded that their intensity
of labor were improved, and most of them agreed that
the EACS should be required in the ED.
Conclusion: The computer-based EACS decreased LOS
by reducing the response time of doctors on duty, and it
also increased satisfaction among the ED health professionals.

영어초록

Purpose: The length of stay (LOS) for patients in the emergency
department (ED) provides an important measure of
both ED overcrowding and patient satisfaction. Specialty
consultation is one of the major factors that contributes to
longer LOS. The aim of the study was to examine the effectiveness
of a computer-based emergency auto-consultation
system (EACS) in reducing additional LOS caused by specialty
consultation.
Methods: The EACS was developed for use in managing
specialty consultation in the ED. Each clinical department
provides a daily list of 4 residents and 1 specialist as the
doctors on duty. The ED doctors then use the EACS to
contact the departments required for a specialty consultation:
Clicking the department’s name on the computer
screen activates the short message service (SMS) calling
system, which sends a message with the registration numbers
and names of the relevant patients every 10 min to the
mobile phones of individuals assigned as doctors on duty,
in the order listed. The doctors who receive the SMS are
asked to arrive at the ED within 10 minutes. If the the firstlisted
doctors on duty do not show up in 10 minutes, an
SMS is sent to the next group of doctors on duty on the list.
In 50 minutes, therefore, 5 groups of doctors on duty will
have received the SMS in the order listed.
Each clinical department estimated the response time of
doctors on duty 2 months before the adoption of the EACS
versus afterward. The LOS of patients admitted to the ED
was also compared before and after the adoption of the
EACS. A questionnaire was used to survey the health professionals
working in the ED about the changes in the
intensity of labor and the needs of the EACS.
Results: The number of patients participating in the study
were 2,035 and 2,216, respectively, before and after the
adoption of the EACS. The EACS significantly decreased
both the response time of doctors on duty (34.8±35.5 min
vs. 9.7±16.8 min, p=0.000) and the LOS (155.3±126.7
min vs. 144.6±110.7 min, p=0.003). In the survey, 44.7%
of ED health care professionals responded that their intensity
of labor were improved, and most of them agreed that
the EACS should be required in the ED.
Conclusion: The computer-based EACS decreased LOS
by reducing the response time of doctors on duty, and it
also increased satisfaction among the ED health professionals.

참고자료

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