The Impact of Involving a Senior Emergency Physician in the Triage Process

Ahmed Alsuliamani — 2024-04-21

BACKGROUND:

Emergency Department (ED) overcrowding has been demonstrated in several studies to be associated with undesirable effects such as longer waiting times, reduced patient satisfaction, and, most importantly, poor patient outcomes. Furthermore, long waiting times for walk-ins result in more complaints and patient dissatisfaction than illness management itself, with the majority of issues arising as a result of real and perceived waiting periods before being seen by the doctor.

AIM:

We set out to investigate whether introducing a senior emergency physician into the triage system would reduce waiting time, door-to-decision time, and door-to-doctor time, as well as increase patient satisfaction across the ED.

METHOD:

This was an interventional pre-post study that utilised retrospective data to evaluate the effect on ED throughput of triage by senior emergency physicians. We aimed to measure its impact on waiting time, door-to-decision time, and door-to-doctor time, along with ED patient satisfaction.

RESULTS:

Patient satisfaction, the overall assessment of treatment received during the visit, increased, from 74.975 to 77.425, and the likelihood of patients recommending the ED increased from 71.36 to 75.21. Operational metrics revealed a considerable drop in door-to-decision time (admit or discharge) of 46 minutes and 3 seconds, as well as a 1 minute and 21 second reduction in time from door to doctor (arrival to first provider).

CONCLUSION:

The mixed results hint at an effective but iterative process of enhancing patient flow and experience in the ED through senior physician triage.

Exercise Capacity and Fatigue in Post-COVID-19 Patients

Hadeel Alqahtani — 2024-04-21

Background:

While many researchers have investigated the influence of COVID-19 on fatigue and quality of life, its impact on exercise capacity has been little considered. It is therefore our aim to examine the impact of COVID-19 on exercise capacity and fatigue among individuals who have recovered from the virus.

Methods:

A cross-sectional study was conducted at the outpatient physical therapy department of a tertiary hospital and Primary health care center. The study comprised 116 participants divided into two groups: a normative group composed of individuals who had not been infected with COVID-19 in the past three months, and a control group consisting of those who had contracted COVID-19 within the preceding three months. The one-minute sit-to-stand test (1STST) was carried out to assess exercise capacity, following which fatigue was measured using the validated Arabic version of the Fatigue Severity Scale (FSS).

Results:

Of the 116 participants enrolled in this study, 76 (65.5%) were in the normative group and 40 (34.5%) in the control group. Following the intervention, the mean FSS score differed significantly between the normative (26.6; SD 10.9) and the control group (36.9; SD 14.8); p-value < 0.001, with participants in the control group reporting higher levels of weariness than those in the normative group. Moreover, as measured by 1STST, the median number of sit-to-stand repetitions completed by participants in the normative group (21.0) was considerably greater than that of the control group (20.0); p-value = 0.025.

Conclusion:

Participants in the control group reported higher levels of fatigue and demonstrated lower exercise capacity than those in the normative group.

The Journal of Medicine, Law & Public Health

The Impact of Involving a Senior Emergency Physician in the Triage Process

Exercise Capacity and Fatigue in Post-COVID-19 Patients