Publication:
How are fast tracks organized in adult and pediatric emergency departments in Switzerland? A cross-sectional survey.

cris.virtualsource.author-orcide8ba8863-6545-472e-9aa5-69e8f2cb2c28
cris.virtualsource.author-orcid2df17c6a-7272-47c8-93e5-c5116a974c1f
cris.virtualsource.author-orcid97bde437-9fb3-46b4-b8df-95f171936414
cris.virtualsource.author-orcid9b30841f-071a-4c9a-8d8d-ed155264ee8e
cris.virtualsource.author-orcid263baf87-3495-4727-8cd4-744c2835e57e
datacite.rightsopen.access
dc.contributor.authorBerger-von Orelli, Franziska G
dc.contributor.authorHertzog, Rebecca A.-B.
dc.contributor.authorSauter, Thomas C.
dc.contributor.authorSeiler, Michelle
dc.contributor.authorSpigariol, Fabian
dc.contributor.authorTomaske, Maren
dc.contributor.authorGualco, Gianluca
dc.contributor.authorDonas, Alex
dc.contributor.authorvon Vigier, Rodo O
dc.contributor.authorKeller, Dagmar I
dc.contributor.authorKeitel, Kristina
dc.date.accessioned2025-04-16T07:18:24Z
dc.date.available2025-04-16T07:18:24Z
dc.date.issued2025-03-18
dc.description.abstractBackground In response to the challenges faced by emergency departments (ED), including overcrowding and high patient volumes, Fast Track (FT) systems are designed to optimize patient flow, yet their implementation and impact in Switzerland remain understudied. Our study provides a comprehensive description of Fast Track (FT) processes across both pediatric and adult settings in Switzerland and compares challenges.Methods We conducted a cross-sectional online survey of ED leadership in Switzerland from May to September 2023, using the WHO SARA framework to explore FT processes. The survey included 28 pediatric EDs and their corresponding adult EDs, with questions addressing FT availability, staffing, infrastructure, and operational challenges. Results were analyzed descriptively, providing insights into FT organization and highlighting barriers to implementation and expansion.Results The survey achieved a response rate of 93% (52/56 EDs). Overall, 68% of surveyed hospitals have implemented a FT system, with a higher prevalence in adult EDs (88%) than in pediatric EDs (59%). The absence of FTs in certain pediatric departments was primarily due to structural and personnel constraints. Most FTs are managed internally by hospitals, employing emergency team members, and occasionally general practitioners, reflecting a tailored approach to staffing based on departmental needs. Despite the strategic organization of FTs, operational challenges persist; 45% of respondents identified staff shortages as a major challenge, particularly in pediatric FTs (63%) compared to adult FTs (32%). Financial barriers, including disparities in external physician compensation, remain significant obstacles to FT expansion. Satisfaction levels among EDs with their FT systems were generally high, with improvements in personnel resource allocation and patient flow frequently reported.Conclusion While FT systems in Swiss EDs have enhanced patient care and operational efficiency, their expansion and effectiveness are hampered by staffing and financial limitations. Addressing these barriers requires a collaborative effort to reform health system policies and financial frameworks, ensuring the sustainable implementation of FTs to meet the growing demands of emergency care.
dc.description.sponsorshipDepartment of Paediatrics
dc.description.sponsorshipDepartment of Emergency Medicine
dc.description.sponsorshipDepartment of Clinical Research (DCR), Director Research
dc.identifier.doi10.48620/87306
dc.identifier.pmid40102922
dc.identifier.publisherDOI10.1186/s12913-025-12570-7
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/207713
dc.language.isoen
dc.publisherBioMed Central
dc.relation.ispartofBMC Health Services Research
dc.relation.issn1472-6963
dc.subjectCross-sectional survey
dc.subjectEmergency department
dc.subjectFast track
dc.subjectLow triage
dc.subjectNon-urgent visits
dc.subjectOvercrowding
dc.subjectPediatric
dc.subjectSelf-referred patients
dc.subjectStaff organization
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleHow are fast tracks organized in adult and pediatric emergency departments in Switzerland? A cross-sectional survey.
dc.typearticle
dspace.entity.typePublication
dspace.file.typetext
oaire.citation.issue1
oaire.citation.startPage395
oaire.citation.volume25
oairecerif.author.affiliationDepartment of Paediatrics
oairecerif.author.affiliationDepartment of Emergency Medicine
oairecerif.author.affiliationDepartment of Clinical Research (DCR), Director Research
unibe.contributor.roleauthor
unibe.contributor.roleauthor
unibe.contributor.roleauthor
unibe.description.ispublishedpub
unibe.refereedtrue
unibe.subtype.articlejournal

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