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{
    "pk": 12347,
    "title": "Impact of Emergency Department Phlebotomists on  Left-Before-Treatment-Completion Rates",
    "subtitle": null,
    "abstract": "Introduction: \nThe emergency department (ED) serves as the primary access point to the healthcare system. ED throughput efficiency is critical. The percentage of patients who leave before treatment completion (LBTC) is an important marker of department efficiency. Our study aimed to assess the impact of an ED phlebotomist, dedicated to obtaining blood specimen collection on waiting patients, on LBTC rates.\nMethods:\n This study was conducted as a retrospective observational analysis over approximately 18 months (October 5, 2015-March 31, 2017) for patients evaluated by a triage provider with a door-to-room (DtR) time of > 20 minutes (min). LBTC rates were compared in 10-min DtR increments for when the ED phlebotomist collected the patient’s specimen vs not.\nResults:\n Of 71,942 patient encounters occurring during the study period, 17,349 (24.1%) met study inclusion criteria. Of these, 1842 (10.6%) had blood specimen collection performed by ED phlebotomy. The overall LBTC rate for encounters included in the analysis was 5.26% (95% confidence interval [CI], 4.94%-5.60%). Weighting the LBTC rates for each 10-min DtR interval using the fixed effects model led to an overall LBTC rate of 2.74% (95% CI, 2.09%-3.59%) for patient encounters with ED phlebotomist collection vs 5.31% (95% CI, 4.97%-5.67%) in those which did not, yielding a relative reduction of 48% (95% CI, 34%-63%). The effect of the phlebotomist on LBTC rates increased as DtR times increased. The difference in the rate of the rise of LBTC percentages, per 10-min interval, was 0.50% (95% CI, 0.19%-0.81%) higher for non-ED phlebotomist encounters vs phlebotomist encounters.\nConclusion:\n ED phlebotomy demonstrated a significant reduction in ED LBTC rates. Further, as DtR times increased, the impact of ED phlebotomy became increasingly significant. Adult EDs with increased rates of LBTC patient encounters may want to consider the implementation of ED phlebotomy.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Phlebotomy, Emergency Services, Organizational Efficiency, Delivery of Health Care, Health Care Quality"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/24z6v2sc",
    "frozenauthors": [
        {
            "first_name": "Jeffrey",
            "middle_name": "R.",
            "last_name": "Stowell",
            "name_suffix": "",
            "institution": "University of Arizona College of Medicine-Phoenix, Department of Emergency Medicine, Phoenix, Arizona;\n\nMaricopa Integrated Health System, Department of Emergency Medicine, Phoenix, Arizona;\n\nCreighton University School of Medicine, Department of Emergency Medicine, Omaha, Nebraska",
            "department": "None"
        },
        {
            "first_name": "Paul",
            "middle_name": "",
            "last_name": "Pugsley",
            "name_suffix": "",
            "institution": "Maricopa Integrated Health System, Department of Emergency Medicine, Phoenix, Arizona",
            "department": "None"
        },
        {
            "first_name": "Heather",
            "middle_name": "",
            "last_name": "Jordan",
            "name_suffix": "",
            "institution": "Maricopa Integrated Health System, Department of Emergency Medicine, Phoenix, Arizona",
            "department": "None"
        },
        {
            "first_name": "Murtaza",
            "middle_name": "",
            "last_name": "Akhter",
            "name_suffix": "",
            "institution": "University of Arizona College of Medicine-Phoenix, Department of Emergency Medicine, Phoenix, Arizona;\n\nMaricopa Integrated Health System, Department of Emergency Medicine, Phoenix, Arizona;\n\nCreighton University School of Medicine, Department of Emergency Medicine, Omaha, Nebraska",
            "department": "None"
        }
    ],
    "date_submitted": "2018-11-22T01:33:57Z",
    "date_accepted": "2018-11-22T01:33:57Z",
    "date_published": "2019-07-02T18:42:52Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/12347/galley/6574/download/"
        }
    ]
}