Emergency Department Overcrowding: Developing Emergency Department Capacity Through Process Improvement

Migita, Russell; Beccaro, Mark Del; Cotter, Dawn; Woodward, George A.

doi:10.1016/j.cpem.2011.04.001

Cited by 19 publications

(14 citation statements)

References 31 publications

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“…Numerous studies have described the implementation of Lean methodologies in the emergency department (ED) setting [3,28,29]. Specifically, Lean methodologies have been utilized in the ED to redesign processes [30•, 31-35], improve patient access and flow [36][37][38][39][40][41][42][43][44][45][46][47], reduce wait times [48][49][50], and to address issues such as errors and ED overcrowding [51]. Our institution has applied Lean methodologies to numerous improvement projects, impacting both clinical and operational practice, summarized in Table 3.…”

Section: Lean In the Emergency Departmentmentioning

confidence: 99%

Improving Patient Flow Using Lean Methodology: an Emergency Medicine Experience

Rutman

Stone

Reid

et al. 2015

Curr Treat Options Peds

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Lean I Quality improvement I Patient flow I Emergency medicine I Pediatrics I Continuous performance improvement I Process I Waste I Value Opinion statement In today's rapidly changing health care milieu, organizations are expected to continuously improve the quality of care delivered to an expanding population of patients. To do so, they need a framework for developing, testing and implementing changes. Lean provides a methodology to engage workers and leaders to identify waste in a process, develop standards, implement a change, assess the results of that change, review next steps, and repeat the process. This can be successfully accomplished in the highly variable world of emergency medicine and can help health care providers be more productive, engaged, and satisfied while enabling patients to receive the value-added care they want and expect. Successful implementation of Lean or any other improvement framework requires that the hospital and medical leadership are all strong supporters of the methodology, speak the same process improvement language and are able to generate support and resources for operation-wide forward movement.

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Section: Lean In the Emergency Departmentmentioning

confidence: 99%

Improving Patient Flow Using Lean Methodology: an Emergency Medicine Experience

Rutman

Stone

Reid

et al. 2015

Curr Treat Options Peds

Self Cite

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“…The need for improvement of the emergency departments is greatly accepted due to the care costs, speed of service delivery, crowd and patient's safety, and with increase in demand for emergency care, hospital managers are seeking new ways to provide more effective health care services (10). Measurement and continuous monitoring are needed to ensure optimal performance of emergency department services and achievement of improvements in every aspect of performance.…”

Section: Introductionmentioning

confidence: 99%

Performance Improvement Priorities From the Perspective of Emergency Department Staff in Iran’s Hospitals

Majidi¹,

Nasiripour²

2016

Crit Care Nurs J

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“…Few people prefer to seek a basic health care center when their child is sick and most use emergency care services, which is justified by liking/trusting the professionals, by geographic accessibility, by speed and quality of service, by previous personal experience, and by resolution (1) . The environment of emergency departments is characterized by the agglomeration of patients, which leads to time pressure and interferes directly in the pediatric care (2) ; therefore, it is necessary to develop processes enabling to establish an adequate connection between emergency care units and the nearest place for the population of a certain locality, in order to ensure a fast and efficient admission (3) . In New Haven, Connecticut, the link between basic health care services and emergency care departments points out the importance of the communication between physicians and staffs from both services, so that the patients are referred only when necessary, resulting in an appropriate referral and counter-referral system (4) .…”

Section: Introductionmentioning

confidence: 99%

A difícil realidade do pronto atendimento infantojuvenil mostrando a situação de saúde de uma cidade

Peixoto

Piazzetta

Rischini

et al. 2013

Rev. paul. pediatr.

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Objective: To analyze the epidemiological profile of children and adolescents aged between 0 to 19 years, assisted by the emergency department of a City School Hospital in order to monitor the health care system of São Carlos, São Paulo, Southeast Brazil.Method: This is a descriptive and cross-sectional study that collected data from medical records, from August 2008 to September 2009 (14 months). The random sample was taken from 15 days of each month, 50% of the total of 26,678 patients seen during that period of time, accounting for 13,339 medical records. The Epi-Info software was used to build the database; results were evaluated by descriptive statistical analysis.Results: Among the analyzed medical reports, 48.3% were female patients, 55% of the patients were aged between 0 and 4 years. Most of the children (95%) came by spontaneous demand. During that period, 41% of the population aged 0 to 19 years-old sought for only this type of health care. The most prevalent diseases were respiratory diseases, which showed 48.5% incidence during fall and winter. Most patients came from the north, northeast, and northwest regions of São Carlos, which have high-population density. Conclusions:The results showed a sad reality, with high spontaneous demand of children aged from zero to four years-old for pediatric emergency care. Most patients had not received prior care from other doctors. The health network situation indicates the need for urgent measures to strengthen the primary care assistance for basic health care centers and family physicians.Key-words: emergency care; health profile; emergency service; child health; Unified Health System. resumo Objetivo: Analisar o perfil epidemiológico de crianças e adolescentes na faixa etária de 0 a 19 anos atendidos no pronto atendimento do Hospital Escola Municipal, de maneira a monitorar a rede de saúde de São Carlos, no estado de São Paulo.Método: Estudo descritivo e transversal com coleta dos dados de prontuários, entre agosto de 2008 e setembro de 2009 (14 meses), sendo uma amostra aleatória, ao acaso, de 15 dias dos atendimentos em 50% das consultas mensais, somando-se 13.339 prontuários de um total de 26.678 atendimentos. Foi construído um banco de dados no programa Epi-Info para análise descritiva.Resultados: Do total, 48,3% dos pacientes eram do sexo feminino, 55% com idades entre zero e quatro anos e 95% oriundos de demanda espontânea. Isso corresponde a um esboço de 41% da população entre 0 e 19 anos de idade que teve somente este tipo de atendimento. Houve predomínio das doenças do aparelho respiratório (48,5%), nos meses de outono e inverno. As regiões que mais utilizaram o pronto The harsh reality of children and youth emergency care showing the health status of a cityatendimento compreenderam bairros das regiões norte, nordeste e noroeste de São Carlos, as quais possuem ampla densidade populacional.Conclusões: Os resultados apontaram a difícil realidade, com alta demanda espontânea, de crianças de zero a quatro anos no pronto atendimento pediátrico, s...

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Emergency Department Overcrowding: Developing Emergency Department Capacity Through Process Improvement

Cited by 19 publications

References 31 publications

Improving Patient Flow Using Lean Methodology: an Emergency Medicine Experience

Improving Patient Flow Using Lean Methodology: an Emergency Medicine Experience

Performance Improvement Priorities From the Perspective of Emergency Department Staff in Iran’s Hospitals

A difícil realidade do pronto atendimento infantojuvenil mostrando a situação de saúde de uma cidade

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