A 5-Year Time Study Analysis of Emergency Department Patient Care Efficiency

Kyriacou, Demetrios N.; Ricketts, V.E.; Dyne, Pamela L.; McCollough, Maureen; Talan, David A.

doi:10.1016/s0196-0644(99)70126-5

Cited by 121 publications

(79 citation statements)

References 29 publications

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“…Derlet and associates 15 concluded that patients for whom ED care was deemed unnecessary could be redirected from the ED without significant adverse outcomes. Studies by Kyriacou and colleagues 9 and Hadjistavropoulos and collaborators 16,17 have illustrated the difficulty of reducing ED length of stay under conditions of fiscal restraint. One Canadian study found that an ED observation unit would be difficult to justify given the small number of patients who would benefit.…”

Section: Potential Solutions To Ed Overcrowdingmentioning

confidence: 99%

“…4 Possible causes include use of the ED for non-emergent cases, 5,6 an aging population, 1 increasing patient acuity, 4 labour shortages, 1,4 lack of community-based alternatives to the ED, 1 delays while waiting for laboratory testing to be completed, 4 lack of public education regarding appropriate ED use and the range of services available in general practitioners' offices, 1,7 lack of long-term care and other alternative settings, 1 and lack of availability of ED or inpatient beds (or both). 1,2,4,[8][9][10][11][12] In contrast to previous studies, which have investigated overcrowding issues within the context of a single ED [1][2][3][4]9,11,12 or addressed specific causes of the problem 8,9,11,[13][14][15] (Predy G, Fraser-Lee N, Gardener K, Edwards J, Brown J, Truman C. Emergency room use for nonurgent medical conditions and the "after hours" accessibility of family physicians in the Capital Health Authority region; unpublished manuscript) we took a systems-based approach, using data from multiple sites within an integrated geographic health region. Such an integrated delivery system offers opportunities for solutions that span the continuum of care in both hospital and community settings.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the causes of overcrowding in emergency departments in the Capital Health Region in Alberta: a focus group study

Estey

Ness²,

Saunders³

et al. 2003

CJEM

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Objectives:To determine the perceptions of health care professionals and service providers with regard to emergency department (ED) overcrowding, including definitions of overcrowding, characteristics of an overcrowded ED, and causes of overcrowding, and secondarily to solicit potential solutions to the problem. Methods: Focus groups were conducted with front-line staff, physicians and managers from 7 EDs within an integrated health region. Participants received questions before the sessions, and an experienced moderator conducted the sessions and prepared transcripts from audio tapes. Analyses included identification of key themes and the interrelationships between those themes. Results: Focus group participants defined service pressures that result in overcrowding as "anything that impedes the flow of patients through the ED, affects the quality of care delivered or results in patient frustration and stress to staff." Overcrowding, which can occur at any time of the day, was perceived to have many causes, including some seasonal factors. Two key problems were identified as causing many spin-off pressures: inefficient access to ED beds (stretchers) because of slow throughput of patients and staff shortages. Other perceived causes included the changing role and use of EDs and limited access to services such as home care, diagnostic imaging, laboratory services, social services and specialist care. Participants generally believed that the characteristics and causes of overcrowding could not be viewed independently; rather, in the search for remedies, they should be considered as interrelated variables. Conclusion: Qualitative studies of this complex issue can identify and describe complex interactions in real-world settings. The findings of such studies can lead to quantitative studies involving objective measurement.

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Section: Potential Solutions To Ed Overcrowdingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding the causes of overcrowding in emergency departments in the Capital Health Region in Alberta: a focus group study

Estey

Ness²,

Saunders³

et al. 2003

CJEM

View full text Add to dashboard Cite

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“…It should be noted that several other important factors can create delays in the time to antibiotic treatment for ED patients with CAP, not just time to CXR. 13 In addition, the benefits of utilizing a predictive tool for CAP in the ED triage setting is highly situational. EDs with shorter times to initial physician assessment may find our proposed clinical algorithm unnecessary, while EDs with large volumes of patients and prolonged waiting times find the algorithm useful.…”

Section: Discussionmentioning

confidence: 99%

Derivation of a Triage Algorithm for Chest Radiography of Community‐acquired Pneumonia Patients in the Emergency Department

Kyriacou

Yarnold²,

Soltysik³

et al. 2008

Academic Emergency Medicine

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“…(10,11) A lot has already been investigated in terms of resource allocation, process standardization, patient classification and prioritization, queuing discipline, implementation of electronic systems and specific process improvements. (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) However, there seem to be no studies that have improved ED functions through operations management based layout planning.…”

Section: Introductionmentioning

confidence: 99%

Improving Emergency Department Capacity Efficiency

Lehtonen

Lukkarinen²,

Kämäräinen³

et al. 2016

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Objective. The demand for emergency services has risen dramatically around the world. Many Emergency Departments (EDs) have signs of low capacity efficiency (which we define as the rate at which a production facility with limited resources can convert input into output); insufficient resources (staffing, equipment, facilities), inefficient ways to use them, or both. Our purpose was to investigate how to improve ED capacity efficiency through layout planning and present some novel ideas of ED bottlenecks.Methods. We adopted an industrial engineering perspective to one Finnish ED as a case example. In contrary to a simple case report we used more generalizable methods and demand-supply chain analysis to improve capacity efficiency.Results. This study resulted in concrete and generalizable improvements of capacity efficiency concerning both ED premises and staffing. The former includes designing patient locations, organizing beds, improving space usage and optimizing an ED layout. The latter identified the demand for different specialties and optimal allocation of nursing staff.Conclusion. We present a rather unique combination of ways to enhance ED functionality by using methods of industrial engineering.

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A 5-Year Time Study Analysis of Emergency Department Patient Care Efficiency

Cited by 121 publications

References 29 publications

Understanding the causes of overcrowding in emergency departments in the Capital Health Region in Alberta: a focus group study

Understanding the causes of overcrowding in emergency departments in the Capital Health Region in Alberta: a focus group study

Derivation of a Triage Algorithm for Chest Radiography of Community‐acquired Pneumonia Patients in the Emergency Department

Improving Emergency Department Capacity Efficiency

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