Thirdly, our comparison groups are matched according to triage category to eliminate confounding variables related to illness severity. Fourthly, this study was designed with a one year “wash-out” period, allowing for stabilization of the FTA operation.

Fifthly, the same months (i.e. January 2005 and January 2006) were compared to eliminate seasonal/cyclic Inhibitors,research,lifescience,medical variation. Finally, there was little change in other potential confounding variables like staffing ratios, bed-patient ratios and the availability of equipment [29]. Since this was a retrospective analysis, nurses and clerical staff who inputted the data were unaware that a study would be conducted, thus avoiding the Hawthorne effect (i.e. people perform differently by being aware of an ongoing Inhibitors,research,lifescience,medical investigation). The studies generalizability is limited to similar ED’s servicing a large proportion of pediatric patients (40%) and who see a high proportion of low acuity patients (65%–70%). Being a retrospective study, we did not measure other more sensitive measures of quality like timeliness of medications, return visits, quality variance reports and subsequent

admissions. Also a time series analysis to detect monthly variability was impractical as we lacked appropriate historical data prior to the intervention of the Inhibitors,research,lifescience,medical FTA. Conclusion This study adds a Middle Eastern perspective of the FTA’s impact on non urgent patients, in a tertiary hospital with a mixed caseload which included pediatric and adult patients. A fast track system appears to be an effective method by which a busy ED can efficiently maintain patient flow in light of restricted resources, space constraints, limited manpower, and an escalating patient census. selleck compound competing interests The authors declare that they have Inhibitors,research,lifescience,medical no competing interests. Authors’ contributions SD conceived on the study, participated in its design and coordination, acquisition of the data, drafting of the manuscript and analysis Inhibitors,research,lifescience,medical and interpretation of the data. HP participated in the study design and critically reviewed the script at all stages for important intellectual content. MVD helped with the acquisition of data, provided administrative Rolziracetam support and reviewed

the manuscript critically. JD was responsible for study supervision and drafting of the manuscript. JR helped with acquisition of the data, analysis and interpretation of the data, critical revision of the manuscript and provided statistical expertise. All authors read and approved the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/9/11/prepub
Road traffic injuries (RTIs) are a major public health problem, requiring concerted efforts [1], in the fields of both crash prevention and post-crash management (PCM). It is often possible to minimize crash consequences by promptly providing effective pre-hospital services [2-8]. Indeed, each year, many of the 1.