April 20, 2022 Emergency

AMC’s Emergency Room Fast-Track Improves Wait Time and Client Satisfaction: A Recent Publication from AMC’s Emergency Department

veterinarians examine a dog

AMC’s Emergency Room Fast-Track Improves Wait Time and Client Satisfaction: A Recent Publication from AMC’s Emergency Department

The World’s Busiest Veterinary Emergency Room

As the world’s largest non-profit hospital, located in the heart of bustling New York City, the AMC’s Emergency Room is one of the busiest veterinary emergency rooms in the country. And though we’re dedicated to compassionate care, the animal ER is often the last place pet owners want to visit. It can be a stressful, nerve-wracking experience to sit next to other fearful pet parents, waiting for your turn to anxiously describe the condition of your ailing animal. When your pet is in distress, the last thing you want to do is wait.

A Pilot Program to Reduce Emergency Room Wait Times

AMC’s experienced emergency medicine specialists recognize the frustration of long wait times, and in 2017, AMC’s Dr. Joel Weltman, Senior Veterinarian, Specialist in Emergency and Critical Care, and Dr. Jennifer Prittie, Department Head of Emergency and Critical Care, launched a pilot study to reduce wait time and improve ER efficiency, published last year in the Journal of Veterinary Emergency and Critical Care. They proposed AMC establish a separate, “Fast Track” service, modeled on the latest advances in human emergency room case flow. This designated Fast Track team would only treat low severity cases (levels 4 and 5 on the chart below), such as mild diarrhea or a tick bite. This Fast Track service would essentially operate like an in-house Urgent Care Clinic, allowing the Emergency Department to prioritize case flow and staffing more efficiently.

To study the impact of the Fast Track service, Drs. Weltman and Prittie compared ER case flow of April 2017 (pre-Fast Track) and April 2018 (post-Fast Track). These two months were statistically matched in terms of patient volume, veterinary staff and case urgency to avoid sampling error.

Fast Track Service Improved Wait Time and Client Satisfaction Across All Urgency Levels

The pilot program was a resounding success: the Fast Track service reduced median wait time across all urgency levels by 29%. The biggest reductions in wait time occurred in urgency levels 3 and 4, the most populous groups in both years. Importantly, wait time did not increase for any group, meaning Fast Track’s expedited care for low urgency cases did not negatively impact wait time for the most severe and urgent cases.

In addition, the Fast Track service had a positive effect on client satisfaction and “case loss.” Case loss – a term used to describe a patient that visits the ER and leaves without being seen – declined by a whopping 42% (77 pets in 2017, 45 pets in 2018) after the implementation of the Fast Track service.

A New Standard in Veterinary Emergency Rooms

The Fast Track service had such a big impact on ER efficiency that it was soon expanded to operate seven days a week at AMC. “By introducing fast-track service,” Drs. Weltman and Prittie write definitively in their article, “resources can be distributed to improve speed of care, case flow, and client satisfaction in the emergency department.” Anecdotally, the authors also note a benefit to ER staff, alleviating stress by better managing the high caseloads in a busy ER like the one at AMC.

Veterinary clinics across the country have taken note. Fast Track service is rapidly becoming a norm in busy emergency rooms, thanks to the pioneering research of Drs. Weltman and Prittie. This is the most gratifying reception a publication could possibly have and why our commitment to pioneering clinical research sets us apart as a veterinary institution.

I’ll be featuring more highlights from AMC staff’s 2021 publications in the coming weeks and months. Stay tuned!

Tags: Dr. Jennifer Prittie, Dr. Joel Weltman, ECC, emergency room, ER Fast Track, fast track service, Urgent Care Fast Track, Veterinary emergency room, veterinary research,

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