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Operations & systems
Embedded low-acuity pathway improves rural ED performance
Embedded Low‐Acuity Pathway in the Emergency Department: An Alternative to Stand‐Alone Urgent Care Services
Emergency Medicine Australasia · Added 15 September 2026
Quasi-experimental study of an embedded ultra-low acuity pathway at Dubbo Base Hospital (n=4,798) — pathway availability halved did-not-wait rates (14.2%→6.9%), lifted seen-on-time and treatment performance, and cut mean ED length of stay by 51.7 minutes.
- Study type
- Cohort
- Design
- Single-centre pragmatic quasi-experimental study
- Participants
- 4,798 ATS Category 4–5 presentations at Dubbo Base Hospital (ULAP 2,178 vs standard care 2,620)
- Main finding
- ULAP was associated with DNW falling from 14.2% to 6.9% (adjusted OR 0.43, 95% CI 0.35–0.53), seen-within-benchmark rising to 82.0% (OR 1.90, 1.64–2.20), ETP rising to 83.3% (OR 1.96, 1.69–2.28), and mean LOS 51.7 minutes shorter (95% CI −65.1 to −38.4).
- Caveat
- Single rural centre, quasi-experimental design with workforce-dependent exposure (risk of confounding).
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). transferability — system redesign rather than clinical care, but directly relevant to where low-acuity patients could be directed instead of transported
Learning goal
Understand how embedded low-acuity pathways reduce did-not-wait rates in rural emergency care.
More
- Topic: Operations & systems
- Daily scan: 15 September 2026
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