PERAN PETUGAS PENGENDALI PELAYANAN MEDIS (P3M) TERHADAP LENGTH OF STAY (LOS) PASIEN DI IGD RS AKADEMIK UGM
The Role of the Emergency Flow Coordinator (EFC) on the Length of Stay (LOS) of Patients In the UGM Academic Hospital’s Emergency Department
Abstract
Background: Overcrowding in Emergency Departments (ED) poses complex challenges, notably regarding patient waiting times or Length of Stay (LOS). The Emergency Flow Coordinator (EFC) at UGM Academic Hospital plays a critical role in regulating patient flow in the ED, yet their specific impact on reducing LOS remains insufficiently defined.
Objective: The aim of this study is to determine the impact of the role of EFC on the Length of Stay (LOS) in the Emergency Department of UGM Academic Hospital
Methods: A cross-sectional study employing structured questionnaires assessed the EFC's function in the ED, gathering responses from all medical personnel (nurses and physicians) on duty. Analysis of secondary data on patient LOS before (from October 2022 to January 2023) and after (from February 2023 to January 2024) EFC implementation was conducted.
Results: According to the Director's Decree of UGM Academic Hospital, the majority of the respondents 90% (45) who assessed EFC (11) considered that EFC plays a very important role in carrying out their job descriptions. From registration to inpatient admission, the average duration of patients in the ED was recorded at 190 minutes (n=9805), which was a decrease of 17.21% from the duration before EFC, which was 229.5 minutes (n=472). The Wilcoxon sum-rank test was used to analyze the difference in LOS between before and after the EFC policy was implemented. The p-value was 0.001, indicating statistical significance.
Conclusions: The EFC is essential in fulfilling its duties, as evidenced by a significant reduction in ED patient LOS following its implementation, enhancing the efficiency of care delivery.
References
Nhdi, Nojoud; Asmari, Hajar; Thobaity, Abdulellah. Investigating Indicators of Waiting Time and Length of Stay in Emergnecy Departments. Open Access Emergency Medicine 2021;13:311–31
College of Emergency Medicine. Crowding in emergency departments. London: College of Emergency Medicine; 2014. Available from https://www.acem.org.au/Standards-Publications/Policies-Guidelines.aspx. Accessed January 13, 2024.
Jarvis PR. Improving emergency department patient flow. Clin Exp Emerg Med. 2016 Jun 30;3(2):63-68. doi: 10.15441/ceem.16.127. PMID: 27752619; PMCID: PMC5051606.
Asha SE, Ajami A. Improvement in emergency department length of stay using a nurse-led 'emergency journey coordinator': a before/after study. Emerg Med Australias. 2014 Apr;26(2):158-63. doi: 10.1111/1742-6723.12201. PMID: 24708005.
Geelhoed GC, de Klerk NH. Emergency department overcrowding, mortality and the 4-hour rule in Western Australia. Med J Aust. 2012;196:122–6.
P. S et al. Impact of an Emergency Nurse Coordinator on Work Flow Optimization in an Emergency Department in Delhi, India. Nursing Informatics. 2016;875-876.
Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006 Jan 1;3(2):77–101
Araszewski D, Peres AM, Montezeli JH, Bolzan MB. The exercising of leadership in the view of emergency room nurses. Cogitare enferm [Internet]. 2014;19(1):41–7. Available from:http://www.revenf.bvs.br/scielo.php?script=sci_arttext&pid=S1414-85362014000100006
Fulbrook P, Jessup M, & Kinnear F. Implementation and evaluation of a “Navigator” role to improve emergency department throughput. Australasian Emergency Nursing Journal. 2017; 20(3):114–121. doi:10.1016/j.aenj.2017.05.004.
Murphy, et al. Does an ED Flow Coordinator Improve Patient Throughput? Journal of Emergency Nursing. 2014; 6: 605-612.
Lee, et al. Multimodal Quality Improvement Intervention With Dedicated Patient Flow Manager to Reduce Emergency Department Length of Stay and Occupancy: Interrupted Time Series Analysis. Journal of Emergency Nursing. 2022; 48: 211-223.
K. Payne, D. Risi, A. O’Hare, et al. Factors that contribute to patient length of stay in the emergency department: A time motion observational study, Autralasian Emergency Care 26. 2023:321-325.
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