Time to CT head in adult patients with suspected traumatic brain injury: Association with the 'Shorter Stays in Emergency Departments' health target in Aotearoa New Zealand
| Autor: | Shanthi Ameratunga, Sue Wells, Peter A. Jones, Waheedah Athaullah, Papaarangi Reid, Joanna Stewart, Alana Harper, James LeFevre, Elana Curtis |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Quality Assurance Health Care Traumatic brain injury 03 medical and health sciences 0302 clinical medicine Brain Injuries Traumatic medicine Humans 030212 general & internal medicine General Environmental Science Quality of Health Care Retrospective Studies National health Adult patients business.industry 030208 emergency & critical care medicine Retrospective cohort study Emergency department Length of Stay Middle Aged medicine.disease Aotearoa Crowding Additional research Patient Discharge Emergency medicine General Earth and Planetary Sciences Female business Emergency Service Hospital Tomography X-Ray Computed New Zealand |
| Zdroj: | Injury. 49(9) |
| ISSN: | 1879-0267 |
| Popis: | A national health target for length of stay in emergency departments (ED) was introduced in 2009 to reduce crowding and improve quality of care. We aimed to determine whether the target was associated with changes in time to CT and appropriateness of CT imaging, as markers of care quality for suspected acute traumatic brain injury (TBI). We undertook a retrospective review of the case records of a random sample of people aged ≥15 years presenting to the ED with TBI from 2006 to 2013. General linear models were used to investigate changes in outcomes along with routine process times before and after the introduction of the target. Among 501 eligible cases the median (IQR) time to CT was 136 (76–247) pre target versus 119 (59–209) minutes post target, p = 0.014. The proportion of appropriate imaging was similar between periods: 77.9% (95% CI 71–83%) versus 76.6% (95%CI 72–81%), p = 0.825. Interactions suggested that the time to CT and appropriateness of imaging before and after the introduction of the target varied by ethnicity, although the changes were not clinically important. Time to assessment and length of stay did not change importantly. We found no evidence of a clinically important change in time to CT or appropriateness of imaging for suspected TBI in association with the introduction of the SSED time target. Additional research with larger cohorts of Māori and Pacific participants is recommended to understand our observed patterns by ethnicity. |
| Databáze: | OpenAIRE |
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