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Is patient flow more efficient in Urgent Care Collaborations?

Gils-van Rooij, E.S.J. van, Meijboom, B.R., Broekman, S.M., Yzermans, C.J., Bakker, D.H. de. Is patient flow more efficient in Urgent Care Collaborations? European Journal of Emergency Medicine: 2018, 25(1), 58-64
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Objective
Emergency Departments and General Practitioner co-operatives collaborate increasingly in Urgent Care Collaborations (UCCs) by sharing one combined entrance and joint triage. The aim of this study is to examine the difference between UCCs and providers who operate separately with respect to the efficiency of patient flow.

Methods
This study had a cross-sectional observational design comparing three regions with UCC with three regions with usual care. Outcome measures were efficiency of patient flow, defined as a reducing length of stay (LOS), waiting time (WT) and the mean number of handovers. Data were obtained from electronic medical records.

Results
LOS (median 34:00 vs. 38:52 min) and WT (median 14:00 vs. 18:43 min) were statistically significantly longer in UCCs compared with usual care. This difference is mainly explained by the prolonged LOS and WT for consulting a General Practitioner. The mean number of interunit handovers was larger in UCCs.

Conclusion
The results indicate that, on average, UCCs do not enhance the efficiency of patient flow. The median LOS and WT are longer in UCCs and more handovers occur in UCCs compared with usual care.