Implementing a Fast Track

Over the past 10 years there has been an increase in the number of emergency room visits. From 1993 to 2013 the number of Emergency Departments in the United States has dropped by more than 500 (AHA, 2013). These changes have caused an increasing overcrowding problem; many researchers have categorized overcrowding as a national crisis. The treatment for low acuity patients is lengthy and ties up resources needed for higher acuity patients. The purpose of this scholarly project was to develop and implement a fast track, through data collection and literature review, which would improve the care of low acuity patients, and result in a decrease in wait times, length of stay, and patients who leave without treatment. There were four main objectives in this project; the first objective was to assess and gather two months of data regarding treatment of low acuity patients prior to the implementation of a fast track in a large emergency department. Second was to implement a fast track area in the emergency department. Objective two includes teaching and training staff on the new process, as well as why and how it is implemented. Objective three included gathering two months of data post implementation of the fast track. Part of objective three included comparing pre and post fast track data to evaluate the efficacy of fast track. The last objective is the dissemination of data to shareholders and emergency department staff. Research has shown overcrowding leads to poor patient outcomes, increased patient safety issues, long wait times, number of patients leaving without treatment, time spent on ambulance divert, and decreased staff and patient satisfaction. Implementation of a fast track has been shown to increase patient flow, improve quality of care for low acuity patients, improve patient and staff satisfaction, and decrease time spent on ambulance divert, and patients leaving without treatment. The goal of this project is the execution of a fast track model in a large emergency department. Implementation included evaluation and discussion of solutions to barriers and needed resources as well as training of ED staff on fast track. Two months of data pre and post implementation of fast track were gathered and compared. Data gathered includes acuity, chief complaint, length of stay, door to MD seen time, and patients who leave without treatment. Both written and visual representation of this data is represented for evaluation. Findings, data, and information about the project will be presented for stakeholders as well as the emergency department staff. Data showed that after the implementation of the fast track there were improvements in door to room, room to doctor seen, doctor seen to disposition, and disposition to departure times. There was also a decrease in the percentage of patients who left without treatment. Fast track is an evidence-based intervention for improved and effective care for low acuity patients.