An evaluation of ‘fast track’ in A&E: a discrete event simulation approach

Abstract

This longitudinal study provides primary evidence on the impact that a fast-track strategy in a hospital Emergency Department has on patient wait time. The study uses a discrete event simulation model to predict output within a variety of triage categories and compares these with post-implementation results. The results of the study indicate a significant reduction in patient wait time with 13.2% of the population waiting longer than 4 h prior to implementation compared with 1.4% post-implementation. However, while this fast-track strategy significantly improves service delivery to patients with minor conditions, service for patients with more acute conditions is not proportionately improved.