The effect of laboratory testing on emergency department length of stay: a multihospital longitudinal study applying a cross-classified random-effect modeling approach.

摘要: Objectives The objective was to examine the relationship between laboratory testing (including test volume and turnaround time [TAT]) emergency department (ED) length of stay (LOS), using linked patient-level data from four hospitals across 4 years. Methods This a retrospective, multisite cohort study patients presenting any one EDs in New South Wales, Australia, during 2-month period (August September) 2008, 2009, 2010, 2011. Data ED information systems were data. A cross-classified random-effect modeling approach applied identify factors affecting LOS, taking into account correlation patients' presentations at same hospital and/or calendar year. Number order episodes (tests ordered point stay) TAT (time receipt result available) examined. Results As number increased, so did duration patient LOS (p < 0.0001). For every five additional tests per episode, median increased by 10 minutes (2.9%, p < 0.0001); each 30-minute increase was, on average, associated with 5.1% (17 minutes; p < 0.0001) after adjustment for other factors. Patients night (7 p.m. 7 a.m.) had longer stays than those daytime, although TATs nights shorter daytime. Conclusions Laboratory has direct effect ED. Laboratory TAT, episodes, influence LOS. Targeted increases resources staffing after-hours may also contribute reductions