Implementation of hospital-wide reform at improving access and flow: Impact on time to antibiotics in the emergency department

Introduction ED overcrowding has been associated with increased mortality, morbidity and delays to essential treatment. It was hypothesised that hospital-wide reforms designed to improve patient access and flow, in addition to improving ED overcrowding, would impact on clinically important processes within the ED, such as timely delivery of antibiotics. Methods A single pre-implementation and post-implementation prospective cohort study was conducted prior to and after a hospital-wide reform (Timely Quality Care (TQC)). Among patients who had intravenous antibiotics prescribed in the ED, data were prospectively collected on times of presentation, prescription and administration of antibiotics. Demographics and discharge diagnoses were retrospectively extracted. Results There were 380 cases included with 179 cases prior to introduction of the TQC model and 201 cases after its introduction. Time from presentation to administration of antibiotics improved significantly from 192 (99–320) min to 142 (81–209) min (P