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Fast Track by physician assistants shortens waiting and turnaround times of trauma patients in an emergency department



We sought to determine whether the introduction of a separate patient flow comprising patients with simple, non-complex health issues [Fast Track (FT)] in a Dutch emergency department setting (ED), without the introduction of additional staff, and treated by a physician assistant, would have favourable effects on waiting and turnaround times without deleterious effects for patients with a higher urgency.

Study design

We used a prospective comparative intervention design for our study.


The waiting times and length of stay for surgical and orthopaedic patients in the ED were measured and compared 3 months before and 3 months after the introduction of FT.


During the study period, 1,289 patients were treated before, and 1,393 after the introduction of FT. After the introduction of FT, we observed a decrease of 12 min (13 %) in the median length of stay for the total group. The median waiting time decreased by 41 min (69 %). The group comprising patients with low to moderate urgency levels showed a median reduction of 12 min in length of stay, whereas the length of stay for urgent patients was reduced by 19 min. The waiting time for the low to moderate urgency patients decreased by 68 min, while the urgent patient group showed a reduction of 32 min.


The introduction of FT performed by a physician assistant resulted in a significant drop in waiting time and length of stay in a Dutch ED setting. This reduction was realised without the allocation of additional staff and even reduced waiting and turnaround times for the patients with a high urgency.

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Conflict of interest

Ed Theunissen declares that he has no conflict of interest. Sacha Lardenoye declares that she has no conflict of interest. Pascal Hannemann declares that he has no conflict of interest. Kevin Gerritsen declares that he has no conflict of interest. Peter Brink declares that he has no conflict of interest. Martijn Poeze declares that he has no conflict of interest.

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Correspondence to M. Poeze.

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Theunissen, B.H.J.J., Lardenoye, S., Hannemann, P.H. et al. Fast Track by physician assistants shortens waiting and turnaround times of trauma patients in an emergency department. Eur J Trauma Emerg Surg 40, 87–91 (2014).

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  • Fast-track
  • Emergency care
  • Waiting time
  • Trauma