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Estrategias que reducen el tiempo de estancia del paciente en la sala de urgencias, revisión sistemática y metaanálisis

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dc.contributor.advisorDevia Jaramillo, Germán Alberto
dc.creatorVelandia Avellaneda, Viviana Andrea
dc.creatorEsmeral Zuluaga, Nathalia María
dc.creator.degreeEspecialista en Medicina de Emergencias
dc.creator.degreeLevelMaestría
dc.date.accessioned2026-02-17T13:08:00Z
dc.date.available2026-02-17T13:08:00Z
dc.date.created2025-05-06
dc.descriptionEl sobrecupo es una condición frecuente en las salas de urgencias, el cual puede estar relacionado con la prolongación del tiempo de estancia de los pacientes en el servicio. En la literatura existen muchas estrategias reportadas con el fin de reducir los EDLOS, sin embargo, no hay claridad en cuáles de estas estrategias son efectivas para la reducción del tiempo de estancia de los pacientes. Basado en esta afirmación, surge la necesidad de establecer cuáles de las estrategias reportadas logran reducir los EDLOS de forma significativa y de esta forma contribuir a la disminución de sobrecupo en las salas de urgencias.
dc.description.abstractBackground Overcrowding is a common issue in emergency departments worldwide. One condition associated with overcrowding is the Emergency Department Length of Stay(EDLOS). Prolonged EDLOS is linked to increased hospitalization costs, worsening clinical outcomes, and deterioration in patient-reported outcomes. Consequently, there is a need to reduce EDLOS, and the scientific literature reports multiple strategies aimed at this goal. Therefore, the objective of this study was to determine strategies statistically significant in reducing the EDLOS. Method A systematic search was conducted in PubMed, Scopus, the Latin American and Caribbean Health Sciences Literature (LILACS) database, and Google Scholar from January 2000 to January 2024. Studies that included patient care strategies in emergency departments to reduce EDLOS, in adults or pediatric populations, and observational or experimental studies were included. The quality of the studies was assessed using the Cochrane Collaboration’s Risk of Bias tool for Interventional Studies, and the certainty of the evidence was evaluated using the Grading of Recom- mendations Assessment, Development, and Evaluation criteria. A mean difference analysis in minutes was performed using a random-effects model. Results A total of 3410 studies were identified using the search strategy with a total of 245,404 patients were ana- lyzed. Three types of strategies were identified with results in reducing EDLOS. Interventions performed by physicians in the triage area (liaison, supervision, and advanced triage) showed a significant reduction of -21.87 min (95% CI -28.35; -15.38). The second intervention was the use of Point-of-Care Testing, which showed a reduction of -41.98 min (95% CI -98.13; 14.15). The third intervention was the creation of fast-track strategies, which documented a reduction of -21.81 min (95% CI -41.79; -1.83). Most of the studies were of the before-and-after type. The certainty of the evi- dence for the first intervention was moderate, while for the other two groups, it was considered low. Conclusion The presence of a physician in the triage team demonstrated a reduction in patient EDLOS, although with high heterogeneity among the analyzed studies. Similarly, the use of fast-track strategies is also signifi- cantly useful in reducing EDLOS, while POCT reduces EDLOS but not significantly.
dc.format.extent61 pp
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_47548
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/47548
dc.language.isoeng
dc.publisherUniversidad del Rosario
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programEspecialización en Medicina de Emergencias
dc.relation.relatedhttps://doi.org/10.1186/s12873-024-01163-y
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectServicios de emergencias
dc.subjectTiempo de estancia
dc.subjectTriage
dc.subjectUnidades de atención rapida
dc.subjectPruebas en el punto de atención
dc.subject.keywordEmergency services
dc.subject.keywordLength of stay
dc.subject.keywordTriage
dc.subject.keywordFast-track
dc.subject.keywordPOCT
dc.titleEstrategias que reducen el tiempo de estancia del paciente en la sala de urgencias, revisión sistemática y metaanálisis
dc.title.TranslatedTitleEffective strategies for reducing patient length of stay in the emergency department: a systematic review and meta‐analysis
dc.typemasterThesis
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de grado
local.department.reportEscuela de Medicina y Ciencias de la Salud
local.regionesBogotá
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