Should SALHN investigate the potential to reduce the number of inpatient admissions from the ED for patients presenting with a lower severity fracture?

This report highlights potential actions that could be taken within the ED, to reduce the number of patients admitted to inpatient beds from the ED.

Guiding questions
 Is there systematic variation in decisions to admit definable groups of patients with similar presenting characteristics from the ED?
 Are there adverse outcomes associated with variation in decisions to admit patients with similar presenting characteristics from the ED?
 Would reducing admissions to inpatient beds from the ED in groups of patients with significant variation in decisions to admit from the ED, improve the flow of patients through the ED?

Analysis
We analysed a dataset comprising all presentations to FMC ED in 2019 to identify patient groups for whom variation in admitting practices in the ED was associated with:
 Utilised capacity within the ED at the time of each new ED presentation, measured by the number of patients already present within the ED.
 Day of the week and time of day of ED presentations, categorised as weekday in-hours, weekday out-of-hours and weekend.

The presented analyses categorise the number of patients within the ED at any one time, as less than 40, 40 to 49, 50 to 59, 60 to 69 and 70 or more.