To what extent the implementation of the See-and-Treat model could it contribute to the management of emergency room overcrowding? A retrospective descriptive study

Introduction: Overcrowding is the situation in which the normal functioning of the Emergency Room (ER) is limited by the disproportion between the health demand, represented by the number of patients waiting and being treated, and the available logistical, instrumental, and professional resources. This phenomenon generates negative consequences not only for patients but also for operators and for the system. The aim of the study is to evaluate the contribution that the implementation of the See and Treat model could offer in an ER with around 45,000 accesses per year.

Materials and Methods: Retrospective descriptive study. The accesses recorded in the ER of a second-level Department of Emergency and Acceptance – “S.Maria” di Terni – in 2018 were analyzed, and the percentage eligible for the See and Treat model was assessed according to the indications adopted by the Tuscany Region.

Results: In 2018 there were 41.646 accesses with exit diagnosis, of which 1,272 were in red code, 11,074 in yellow code, 25,129 in green code, and 4,175 in white code. 4846 cases were eligible for the See and Treat model, equal to 11.63% of total cases and 16.53% of "low priority" cases.

Discussion: The data obtained show that the See and Treat model could significantly contribute to the management of low priority in the ER, improving its functioning.

Conclusions: Minor emergencies account for most of the accesses to the ER. The presence of adequately trained nurses can contribute significantly to the management of minor emergencies in the ER, bringing benefits for both professionals and users. What emerged from the study can also contribute to developing the debate on the advanced skills of the nurse.