Patient throughput times and inflow patterns in Swedish emergency departments. A basis for ANSWER, A National SWedish Emergency Registry

Abstract

ObjectiveQuality improvement initiatives in emergency medicine (EM) often suffer from a lack of benchmarking data on the quality of care. The objectives of this study were twofold: 1. To assess the feasibility of collecting benchmarking data from different Swedish emergency departments (EDs) and 2. To evaluate patient throughput times and inflow patterns.MethodWe compared patient inflow patterns, total lengths of patient stay (LOS) and times to first physician at six Swedish university hospital EDs in 2009. Study data were retrieved from the hospitals' computerized information systems during single on-site visits to each participating hospital.ResultsAll EDs provided throughput times and patient presentation data without significant problems. In all EDs, Monday was the busiest day and the fewest patients presented on Saturday. All EDs had a large increase in patient inflow before noon with a slow decline over the rest of the 24 h, and this peak and decline was especially pronounced in elderly patients. The average LOS was 4 h of which 2 h was spent waiting for the first physician. These throughput times showed a considerable diurnal variation in all EDs, with the longest times occurring 6-7 am and in the late afternoon.ConclusionThese results demonstrate the feasibility of collecting benchmarking data on quality of care targets within Swedish EM, and form the basis for ANSWER, A National SWedish Emergency Registry.

Likelihood of acute coronary syndrome in emergency department chest pain patients varies with time of presentation

“…The present inflow pattern of chest pain patients was very similar to the overall patient inflow at our and other [24-26] EDs, with a noon peak and an early morning nadir. Further, the inflow pattern of ACS patients was similar to that reported for AMI patients in the UK [27].…”

“…Although the diurnal presentation pattern and the age and sex distribution suggest that our patients were similar to those in other EDs [24-27], the present results need to be confirmed in other patient populations and health care settings. No follow-up was performed of the patients sent home from the ED, and a small fraction of the ACS cases might therefore have been missed.…”

Assessing time to treatment and patient inflow in a Danish emergency department: a cohort study using data from electronic emergency screen boards

“…Most patient contacts were on Mondays while Saturdays showed the fewest patient contacts. Despite different settings and countries Arkun et al and Ekelund et al [ 14 , 17 ] also found Monday to be the busiest day in their EDs. In addition Ekelund et al [ 17 ] too found Saturday to have the fewest patient contacts.…”

Factors associated with the length of stay of patients discharged from emergency department in France

“…These missing variables may play an important role [26] that should be assessed in future studies. First, because of a high proportion of missing values, we could not include the characteristics of the final diagnosis of the patients who visited the ED.…”