Effects of Emergency Transfer Coordination Center on Length of Stay of critical patients in the Emergency department

Introduction Critically ill patients are frequently transferred from other hospitals to the Emergency department (ED) of tertiary hospitals. Due to the unforeseen transfer, the ED length of stay (LOS) of the patient is likely to be prolonged along with other adverse effects. The present study aimed to confirm whether the establishment of an organized unit called the Emergency Transfer Coordination Center (ETCC) to systematically coordinate emergency transfers is effective in reducing the ED LOS of transferred critically ill patients. Methods The present study is a retrospective observational study focusing on patients who were transferred from other hospitals and admitted to the intensive care unit (ICU) of the ED in a tertiary hospital located in northwestern Seoul, the capital city of South Korea from January 2019 to December 2020. The exposure variable of the study was ETCC approval before transfer and ED LOS was the primary outcome. Propensity score matching was used for comparison between the group with ETCC approval and the control group. Results Participants comprised 1097 patients admitted to the ICU after being transferred from other hospitals, of which, 306 patients (27.9%) were transferred with ETCC approval. The median ED LOS in the ETCC approved group was significantly reduced to 277 minutes compared to 385 minutes in the group without ETCC approval. ETCC had a greater effect on reducing evaluation time than boarding time, which was the same for populations with different clinical features. Conclusion ETCC can be effective in systematically reducing critical patients’ ED LOS who are transferred from other hospitals to tertiary hospitals suffering from severe crowding.