Streaming by case complexity: evaluation of a model for emergency department Fast Track.

Objectives: To evaluate a patient flow streaming system within a teaching hospital's ED, using functional principles to separate patients into two streams on the basis of complexity rather than acuity, severity or disposition.

Methods: The project used conceptual principles, such as patient complexity and 'lean thinking' theory, to create a new Fast Track patient stream, which was separately resourced. Data collected before and after implementation of the Fast Track system were analysed to evaluate the system.

Impact of a chest-pain guideline on clinical decision-making.

Objective: To evaluate the impact of a chest-pain guideline on clinical decision-making and medium-term outcomes of patients presenting to a hospital emergency department (ED) with non-traumatic chest pain.

Design: Before-and-after guideline implementation study.

Setting: Bankstown-Lidcombe Hospital, Sydney, NSW (454-bed metropolitan teaching hospital), in the six-month periods before and after guideline implementation in February 2001.