Faculty triage shortens emergency department length of stay.

OBJECTIVE: To determine whether faculty triage (FT) activities can shorten emergency department (ED) length of stay (LOS). METHODS: This was a comparison study measuring the impact of faculty triage vs no faculty triage on ED LOS. It was set in an urban county teaching hospital. Subjects were patients presenting to the registration desk between 9 AM and 9 PM on 16 consecutive Mondays (August 2 to November 15, 1999). On eight Mondays, an additional faculty member was stationed at the triage desk. He or she was asked to expedite care by rapid evaluation orders for diagnostic studies and basic therapeutic interventions, and by moving serious patients to the patient care areas. He or she was not provided with detailed instructions or protocols. The ED LOS, time of registration (TIMEREG), inpatient admission status (ADMIT), x-ray utilization (XRAY), total patients registered each day between 9 AM and 9 PM (TOTREG), and patients who left without being seen (LWBS) were determined using an ED information system. The LOS was analyzed in relation to FT, ADMIT, and XRAY by the Mann-Whitney U test. The LOS was related to TIMEREG and TOTREG by simple linear regression. Stepwise multiple linear regression models to predict LOS were generated using all the variables. RESULTS: Patients without FT (n = 814) had a mean LOS of 445 minutes. Patients with FT (n = 920) had a mean LOS of 363 minutes. Mean difference in LOS was -82 minutes (95% CI = -111 to -53), a reduction of 18%. The LOS was also related to: ADMIT +203 minutes (95% CI = 168 to 238), TOTREG -2.7 min/additional patient registered (95% CI = -1.15 to -4.3), and TIMEREG +0.14 min/min since 9 AM (95% CI = 0.07 to 0.21). The LWBS was reduced by 46% with FT. In multiple regression analysis, ADMIT, FT, TIMEREG, and XRAY were all related to LOS, but the model explained only a small part of variance (adjusted R(2) = 0.093). The faculty cost is estimated to be $11.98/patient. CONCLUSIONS: Faculty triage offers a moderate increase in efficiency at this ED, albeit with relatively high cost.

Influence of moderate daily wine consumption on body weight regulation and metabolism in healthy free-living males.

OBJECTIVE: Although previous studies have clearly demonstrated that energy from alcohol may not be efficiently utilized to maintain body weight when it comprises 20% or more of the daily caloric intake, there is considerable debate regarding the influence of moderate alcohol consumption (< or = 5% of the total daily caloric intake) upon metabolism, substrate utilization and body weight regulation. Consequently, the objectives of this study were to determine whether moderate alcohol consumption could influence body weight via changes in substrate utilization, oxygen consumption or alterations in dietary macronutrient content. METHODS: Fourteen male subjects (mean age = 32.1 years) participated in a 12-week, free-living, crossover trial in which they either drank red wine (270 ml; 13% v/v ethanol) daily for 6 weeks and then abstained for the next 6 weeks or vice-versa. RESULTS: Whether wine was imbibed or not, no significant differences (p > 0.05) were demonstrated for any of the following variables: body weight, body fat percentage, skinfold thickness, resting metabolic rate, respiratory quotient, caloric intake, dietary macronutrient content, or fasting insulin or glucose concentrations. CONCLUSIONS: In free-living subjects over a 6-week period, the addition of two glasses of red wine to the evening meal does not appear to influence any measured variable which may adversely affect body weight or promote the development of obesity during this time period.