ABSTRACT
OBJECTIVE: To examine the effect of fast track on emergency department (ED) length of stay (LOS). DESIGN AND SETTING: Pair-matched case-control design in a public teaching hospital in metropolitan Melbourne, Australia. PARTICIPANTS: Patients treated by the ED fast track (cases) between 1 January and 31 March 2007 were compared with patients treated by the usual ED processes (controls) from 1 July to 15 November 2006 (n = 822 matched pairs). INTERVENTION: ED fast track was established in November 2006 and focused on the management of patients with non-urgent complaints. MAIN OUTCOME MEASURES: The primary outcome measure was ED LOS for fast-track patients. Secondary outcomes were waiting times and ED LOS for other ED patients. RESULTS: Median ED LOS for non-admitted patients was 132 minutes (interquartile range (IQR) 83-205.25) for controls and 116 minutes (IQR 75.5-159.0) for cases (p<0.01). Fast-track patients had a significantly higher incidence of discharge within 2 h (53% vs 44%, p<0.01) and 4 h (92% vs 84%, p<0.01). CONCLUSIONS: ED fast track decreased ED LOS for non-admitted patients without compromising waiting times and ED LOS for other ED patients.
Subject(s)
Emergency Service, Hospital/organization & administration , Length of Stay/statistics & numerical data , Triage/organization & administration , Adolescent , Adult , Case-Control Studies , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Male , Patient Admission/statistics & numerical data , Patient Discharge/statistics & numerical data , Severity of Illness Index , Time Factors , Triage/statistics & numerical data , Victoria , Young AdultABSTRACT
We present a study of the orientational dynamics of aqueous solvation shells of halogenic anions in bulk water solution with femtosecond two-color midinfrared spectroscopy. These orientational dynamics have time constants between 2.5 and 12 ps, depending on the type of anion and the temperature. We find that the solvation shell of the larger ion I- shows faster dynamics than that of the smaller ions Cl- and Br-.
ABSTRACT
We report on the direct measurement of the dynamics of water molecules in the solvation shell of an ion in aqueous solution. The hydrogen-bond dynamics of water molecules solvating a Cl-, Br-, or I- anion is slow compared with neat liquid water, indicating that the aqueous solvation shells of these ions are rigid. This rigidity can play an important role in the overall dynamics of chemical reactions in aqueous solution. The experiments were performed with femtosecond midinfrared nonlinear spectroscopy, because this technique allows the spectral response of the water molecules in the solvation shell to be distinguished clearly from that of the other water molecules in the solution.
