Are emergency medical services offload delay patients at increased risk of adverse outcomes?

6Citations
Citations of this article
51Readers
Mendeley users who have this article in their library.

Abstract

Objective Emergency department (ED) and hospital overcrowding cause offload delays that remove emergency medical services (EMS) crews from service and compromise care delivery. Prolonged ED boarding and delays to inpatient care are associated with increased hospital length of stay (LOS) and patient mortality, but the effects of EMS offload delays have not been well studied.Methods We used administrative data to study all high-acuity Canadian Triage Acuity Scale 2-3 EMS arrivals to Calgary adult EDs from July 2013 to June 2016. Patients offloaded to a care space within 15 minutes were considered controls, whereas those delayed ≥ 60 minutes were considered delayed. Propensity matching was used to create comparable control and delayed cohorts. The primary outcome was 7-day mortality. Secondary outcomes included hospital LOS and 30-day mortality.Results Of 162,002 high-acuity arrivals, 70,711 had offload delays <15 minutes and 41,032 had delays > 60 minutes. Delayed patients were more likely to be female, older, to have lower triage acuity, to live in dependent living situations, and to arrive on weekdays and day or evening hours. Delayed patients less often required admission and, when admitted, were more likely to go to the hospitalist service. Main outcomes were similar for propensity-matched control and delayed cohorts, although delayed patients experienced longer ED LOS and slightly lower 7-day mortality rates.Conclusion In this setting, high-acuity EMS arrivals exposed to offload delays did not have prolonged hospital LOS or higher mortality than comparable patients who received timely access.

References Powered by Scopus

MatchIt: Nonparametric preprocessing for parametric causal inference

3139Citations
N/AReaders
Get full text

The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments

717Citations
N/AReaders
Get full text

Increase in patient mortality at 10 days associated with emergency department overcrowding

658Citations
N/AReaders
Get full text

Cited by Powered by Scopus

The influence of ambulance offload time on 30-day risks of death and re-presentation for patients with chest pain

12Citations
N/AReaders
Get full text

Exploring paramedic perspectives on emergency medical service (EMS) delivery in Alberta: a qualitative study

3Citations
N/AReaders
Get full text

Is the fast-track process efficient and safe for older adults admitted to the emergency department?

3Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Stewart, D., Lang, E., Wang, D., & Innes, G. (2019). Are emergency medical services offload delay patients at increased risk of adverse outcomes? Canadian Journal of Emergency Medicine, 21(4), 505–512. https://doi.org/10.1017/cem.2018.478

Readers over time

‘19‘20‘21‘22‘23‘24‘250481216

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 9

45%

Researcher 7

35%

Lecturer / Post doc 3

15%

Professor / Associate Prof. 1

5%

Readers' Discipline

Tooltip

Medicine and Dentistry 12

52%

Nursing and Health Professions 9

39%

Pharmacology, Toxicology and Pharmaceut... 1

4%

Computer Science 1

4%

Save time finding and organizing research with Mendeley

Sign up for free
0