SHM Converge Scientific Abstract ePoster Gallery-Fast Track Dialysis 2: 2 Fast 2 Furious

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Emory University Hospital Midtown (EUHM) launched a Fast Track Dialysis (FTD) program in 2017 to identify low-risk emergency department patients who needed hemodialysis and provide treatment more efficiently. The program involved collaboration among hospital medicine, emergency medicine, nephrology, dialysis nursing, and ED nursing. In its first year, FTD reduced hospital length of stay (LOS) from 27 hours to 12.8 hours and lowered charges from $30,600 to $26,040.<br /><br />In year 2 (FTD2), the program at EUHM shifted from hospital medicine management to emergency medicine management in the clinical decision unit (CDU). The FTD pathway was also introduced at Emory University Hospital (EUH). Researchers compared outcomes from December 2018 to November 2019 with baseline FTD year 1 data.<br /><br />At EUHM, the historical control group included 143 patients and the FTD2 cohort included 216 patients. Median daytime LOS did not change significantly (12.8 vs. 12.92 hours), but median charges dropped sharply (from 26,040 to 7,127) and discharge-to-door time improved substantially (from 2.44 to 0.62 hours).<br /><br />At EUH, 66 patients were in the control group and 174 in the FTD2 cohort. LOS decreased modestly from 10.63 to 9.88 hours, though some encounters had incomplete LOS data. Median charges increased slightly (4,460 to 5,459), while door-to-discharge time improved significantly (0.42 to 0.14 hours).<br /><br />Overall, use of the FTD pathway increased at both sites. The findings suggest that simply initiating the pathway reduces LOS, regardless of whether patients are managed in the CDU or on hospital floors. However, CDU-based FTD appears to allow faster discharge and lower charges than inpatient observation.

Asset Subtitle

Kyle James

Meta Tag

Author List Christopher M. O'Donnell, Daniel Wood, Ethan Molitch-HoU, George Hughes, Kyle James, Michael Chuck Perry, Michael Ross, Nicole Franks, Sarah Nicholls, Tahsin Masud, Traci Leong, Vena R. Crichlow

Category Research

Concept Fast Track Dialysis

Concept Hemodialysis

Concept Multidisciplinary Collaboration

Concept Length of Stay

Concept Hospital Charges

Distinguished Non-Finalist

Presenter Organization Emory University Hospital Midtown

Presenting Author Kyle James

Track Quality Improvement

Keywords

Fast Track Dialysis

hemodialysis

emergency department

clinical decision unit

length of stay

hospital charges

discharge time

nephrology

patient outcomes

Emory University Hospital

Fast Track Dialysis

Hemodialysis

Multidisciplinary Collaboration

Length of Stay

Hospital Charges