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Authors: Yuri Adi Priya Kawashima , Samer Elkhodair , Robert Pinate , Robert Altaher Abdalla , Sergio Sawh

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Abstract

Patients who present to the Emergency Department (ED) are often unselected when they arrive in the department. Increased demand in the ED of hospitals is a significant concern for healthcare systems globally. One of the goals of establishing a "Rapid Assessment and Treatment" (RAT) area within most modern EDs is that senior clinicians can assess and initiate life-saving treatment on unwell patients. We collected data between April and December 2023, investigating the outcome of 45,951 patients who were processed in the RAT sections of the department against recommended best standards. Data comparison with quality standard from NICE guidelines, RCEM, RCP and Academy of Medical Royal Colleges and the American Heart Association (AHA). Time from arrival to assessment (RAT note by a clinician) (1) Time to Antibiotic (AB): AB administration with 1h as recommended by the Academy of Medical Royal Colleges (2) Time to Analgesia: initial assessment for the pain within 15 minutes of arrival and re-evaluate in 60 min as recommended by the RCEM (3) Time to ECG order: Take a resting 12‑lead ECG as soon as possible: within 10 min as recommended by the AHA (4) Time to Imaging: Xray/ CT: CT head trauma or CT acute stroke on appropriate patients within one hour if they meet the criteria (5,6) The national target for hospitals included in the NHS Standard Contract states that all handovers between ambulance and A&E must take place within 15 minutes, with none waiting more than 30 minutes (7)

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Keywords: improve patient flow/ deliver safer, faster and better

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