Analysing the emergency department patient journey: Discovery of bottlenecks to emergency department patient flow

Abstract

The results reinforces the need for a whole-of-hospital effort to address flow bottlenecks, and identify moving a patient from emergency to inpatient care as the critical bottleneck in ED system performance.

When a health policy cuts both ways: Impact of the National Emergency Access Target policy on staff and emergency department performance

“…Access block, defined as admitted patients spending more than 8 h in the ED, is the principal cause of ED overcrowding and remains the major problem confronting EDs worldwide . After the introduction of a 4‐h time‐based ED performance target in the UK, it was modified and introduced in Western Australia (WA) in 2009, and then across Australia in 2012 . The Four‐Hour Rule/National Emergency Access Target (4HR/NEAT) requires that most patients presenting to an ED should be seen, admitted or discharged within 4 h, when appropriate …”

“…[1][2][3] After the introduction of a 4-h timebased ED performance target in the UK, [4][5][6] it was modified and introduced in Western Australia (WA) in 2009, and then across Australia in 2012. [7][8][9][10] The Four-Hour Rule/National Emergency Access Target (4HR/NEAT) requires that most patients presenting to an ED should be seen, admitted or discharged within 4 h, when appropriate. 7,11,12 The 4HR/NEAT policy has had an impact with modest to major improvements in access block, excess mortality 9,[13][14][15][16][17] and other patient flow and outcome measures.…”

Impact of the National Emergency Access Target policy on emergency departments’ performance: A time‐trend analysis for New South Wales, Australian Capital Territory and Queensland

“…[1][2][3] Access block, leading to prolonged ED length of stay (EDLOS) for admitted patients has been associated with ED overcrowding. NSW and QLD, but not ACT, showed significant improvements in time-based measures.…”

Collaborative research between emergency medicine and physicians

“…These measures reduce hospital overcrowding and congestion despite increasingly constrained hospital bed platforms and healthcare funding. There is now agitation for a whole‐of‐hospital approach to address patient flow bottlenecks, with enhanced movement of patients from emergency to inpatient critical care that underpin improved outcomes . These measures, now widely adopted by hospitals, have reduced lengths of stay from arrival to hospital discharge for improved patient journeys.…”

“…There is now agitation for a wholeof-hospital approach to address patient flow bottlenecks, with enhanced movement of patients from emergency to inpatient critical care that underpin improved outcomes. [3][4][5] These measures, now widely adopted by hospitals, have reduced lengths of stay from arrival to hospital discharge for improved patient journeys. Patients are more satisfied and the clinical outcomes are better with enhanced efficiencies and reduced costs.…”