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Impact of a pilot pathway for the management of gastroenteritis‐like symptoms in an emergency department: A case study following a Salmonella outbreak
Author(s) -
Ranse Jamie,
Luther Matt,
Ranse Kristen
Publication year - 2016
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12497
Subject(s) - medicine , emergency department , outbreak , audit , exact test , emergency medicine , intervention (counseling) , public health , medical record , retrospective cohort study , health care , pediatrics , nursing , virology , psychiatry , management , economics , economic growth
Objective This research aims to describe the effect of standard care (control) versus a clinical management pathway (intervention) on patient length of stay and admission rates during a public health emergency at one Australian ED. Methods A retrospective audit of hospital records for patients who presented in May 2013 with gastroenteritis‐like symptoms was undertaken following a surge in patient presentations from a Salmonella outbreak. Patients who presented with gastroenteritis‐like symptoms between 15 and 19 May 2013 received care according to a clinical management pathway (intervention). The focus of the intervention was based on symptom management, including a standardised approach to analgesia, anti‐emetics and rehydration. Patient characteristics, such as age and gender are described using descriptive statistics. A Mann–Whitney test was used to compare continuous data, and a Fisher's exact test was used to compare categorical data, between the two groups. Results Over an 8 day period, 110 patients presented with gastroenteritis‐like symptoms. The median length of stay was statistically different between the two groups ( P < 0.001). More patients were admitted to hospital from the control group ( n = 5) when compared with the intervention group ( n = 0); however, given the small number of patients in these groups, inferential statistical analysis was not a reasonable consideration. Conclusion The length of stay for patients between the two groups was statistically different, suggesting that the implementation of a clinical management pathway for patients with gastroenteritis‐like symptoms reduced the ED length of stay. This finding is useful in future planning for similar public health emergency responses and/or for use when patients present with gastroenteritis‐like symptoms on a daily basis.