The effect of vertical split-flow patient management on emergency department throughput and efficiency

被引:26
作者
Garrett, John S. [1 ]
Berry, Colyn [1 ]
Wong, Hao [1 ]
Qin, Huanying [2 ]
Kline, Jeffery A. [3 ,4 ]
机构
[1] Baylor Univ, Med Ctr, Dept Emergency Med, 3500 Gaston Ave, Dallas, TX 75246 USA
[2] Baylor Scott & White Healthcare Syst, Dept Quantitat Sci, Suite 500,8080 North Cent Expressway, Dallas, TX 75206 USA
[3] Indiana Univ Sch Med, Dept Emergency Med, 340 West 10th St, Indianapolis, IN 46202 USA
[4] Indiana Univ Sch Med, Dept Physiol, 340 West 10th St, Indianapolis, IN 46202 USA
关键词
Split flow; Vertical split flow; Efficiency; Emergency department; Throughput; FAST-TRACK; PEDIATRIC EMERGENCY; CARE;
D O I
10.1016/j.ajem.2018.01.035
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: To address emergency department overcrowding operational research seeks to identify efficient processes to optimize flow of patients through the emergency department. Vertical flow refers to the concept of utilizing and assigning patients virtual beds rather than to an actual physical space within the emergency department to care of low acuity patients. The aim of this study is to evaluate the impact of vertical flow upon emergency department efficiency and patient satisfaction. Methods: Prospective pre/post-interventional cohort study of all intend-to-treat patients presenting to the emergency department during a two-year period before and after the implementation of a vertical flow model. Results: In total 222,713 patient visits were included in the analysis with 107,217 patients presenting within the pre-intervention and 115,496 in the post-intervention groups. The results of the regression analysis demonstrate an improvement in throughput across the entire ED patient population, decreasing door to departure time by 17 min (95% CI 15-18) despite an increase in patient volume. No statistically significant difference in patient satisfaction scores were found between the pre- and post-intervention. Conclusions: Initiation of a vertical split flow model was associated with improved ED efficiency. (C) 2018 Elsevier Inc. All rights reserved.
引用
收藏
页码:1581 / 1584
页数:4
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