Background: At our 60,000 annual visit Level 1 teaching hospital, Emergency Physicians do not have admitting privileges. Instead, we must request admission to an inpatient service. Medical Center Policy allows inpatient teams 90 minutes to act upon this request. However, most admit requests to the General Medicine Service fail to meet this time requirement. In an effort to improve compliance and performance, a "FAST TRACK" admit request was created. This study seeks to evaluate the effect on the admission acceptance time before and after initiation.
Methods: Our observational study investigated admission requests to the general medical service at an academic medical center between 7/30/18-12/15/18. On 10/6/18 a “FAST TRACK” admission request was implemented for expediting admissions of patients with a high likelihood for acceptance to a non-ICU, general medical bed. Retrospective analysis was performed on EMR data (EPIC) before and after the implementation.
Results: A total of 1,994 “admit requests” to the medical service were included in the study. The pre-implementation mean request response time for 1024 “FAST TRACK” requests was 139 minutes (95% C.I. 133-146) with a median time of 112 minutes. Following implementation, the overall mean for 970 requests was 128 minutes (95% C.I. 119-137). This represented a significant overall reduction in mean action time [Wilcoxon Rank Sum (p < 0.0001)]. The mean for 214 “FAST TRACK” admit requests was 111 minutes and median 85 minutes. The mean for the other 756 admit requests was 133 minutes and median 91 minutes.
Conclusion: Implementation of a “FAST TRACK” admission request resulted in a statistically significant reduction in overall response time for admission requests to the General Medicine Service. “FAST TRACK” designated cases demonstrated a clinically significant reduction and improved compliance with Medical Center Policy.