ArticleJournal of the American College of Emergency Physicians open2026
Implementation and Validation of an Emergency Department Consult Tracking Tool for Monitoring Consultant Turnaround Times.
Article in Journal of the American College of Emergency Physicians open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
11 authors.
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Abstract
Objectives: To evaluate the implementation of an electronic health record (EHR)-integrated consult tracking tool and assess its utilization in capturing emergency department (ED) specialty consultant turnaround times at an academic, tertiary care medical center. Methods: This quality improvement study was conducted at a tertiary academic medical center from December 2023 through February 2025. The Epic ASAP Consult Tracker was implemented to capture discrete timestamps for ED specialty consultations. A 3-month validation period (December 2023-February 2024) used manual scribe review of 5401 consultations to verify tool accuracy against surrogate documentation methods. From March 2024 onward, the tool operated independently with automated monthly reporting. Primary outcomes were tool utilization rate and median consultation turnaround time, defined as the interval from consult order entry to receipt of actionable consultant recommendations. Results: Over the 12-month post-validation period (March 2024-February 2025), 34,663 consultations were tracked across 26 specialty services. During validation, the tracking tool captured shorter median turnaround times (139 minutes) than surrogate methods, including ED course documentation (238 minutes), disposition time (179 minutes), and consultant note signature (273 minutes). The mean monthly utilization rate was 53.3% (SD 4%; range 44.4%-57.8%). The overall median consultation turnaround time was 108 minutes, with substantial specialty-specific variation: the medical intensive care unit had the shortest median response time at 59.5 (IQR: 37.4-97.1), whereas psychiatry had the longest at 195.6 (IQR: 122.6-299.6). Conclusion: An EHR-integrated consult tracking tool is a feasible method for measuring ED consultation turnaround times. The tool was used to document consultation milestones and identified and revealed specialty-specific variation in consultation response times. These findings provide a foundation for future efforts to evaluate consultation processes and improve ED operations.
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