Although Emergency Department (ED) crowding remains a national problem, efforts to
improve ED process efficiency and optimize throughput can potentially increase functional
ED capacity [
[1]
,
- Institute of Medicine, Committee on the Future of Emergency Care in the United States Health System
Hospital-based emergency care: at the breaking point.
http://www.iom.edu
Date: 2006
[2]
]. As a frequently occurring process with potential for significant waste and complexity,
handoffs between the ED and inpatient teams represent an opportunity to apply systems
improvement science and reduce delays [
[3]
,
[4]
]. In addition, the inpatient handoff process represents the final bottleneck in patient
progression through many EDs and thus is a particularly important area of focus given
the theory of constraints and potential effects on ED and hospital capacity utilization
[
5
,
6
,
7
]. Systems engineering methodologies have demonstrated success in other areas of ED
process flow [
8
,
9
,
10
]. Therefore, we hypothesized that a multidisciplinary, Lean-based effort involving
different stakeholder groups could achieve improved handoff process efficiency and
reduced turnaround times.Keywords
To read this article in full you will need to make a payment
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Hospital-based emergency care: at the breaking point.(Available at)http://www.iom.eduDate: 2006
- Systematic review of emergency department crowding: causes, effects, and solutions.Ann Emerg Med. 2008; 52: 126-136
- Models for improving patient throughput and waiting at hospital emergency departments.J Emerg Med. 2012; 43: 1119-1126
- A conceptual model of emergency department crowding.Ann Emerg Med. 2003; 42: 173-180
- The impact of input and output factors on emergency department throughput.Acad Emerg Med. 2007; 14: 235-242
- Describing wait time bottlenecks for ED patients undergoing head CT.Am J Emerg Med. 2017; 35 ([2017 May 1]): 1510-1513
- Boarding inpatients in the emergency department increases discharged patient length of stay.J Emerg Med. 2013; 44: 230-235
- The improvement guide: a practical approach to enhancing organizational performance.2nd ed. Jossey-Bass, San Francisco2009: 36-37
- Applying lean methodologies reduces ED laboratory turnaround times.Am J Emerg Med. 2015; 33: 1572-1576
- Using lean-based systems engineering to increase capacity in the emergency department.West J Emerg Med. 2014; 15: 770-776
- Lean hospitals: Improving quality, patient safety, and employee satisfaction.Productivity Press, Boca Raton, FL2012
Article Info
Publication History
Published online: November 06, 2018
Accepted:
November 5,
2018
Received:
October 30,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
