Improving Service Quality by Understanding Emergency Department Flow: A White Paper and Position Statement Prepared For the American Academy of Emergency Medicine

Journal of Emergency Medicine

Volumn 38, Issue 1, 2010, Pages 70-79

  Eitel, Dave R ^a   Rudkin, Scott E ^b   Malvehy, M Albert ^c   Killeen, James P ^d   Pines, Jesse M ^e,f  

^a YORK HOSPITAL   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c Durham Regional Hospital   (United States)

^d UNIVERSITY OF CALIFORNIA   (United States)

^e UNIVERSITY OF PENNSYLVANIA   (United States)

^f UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

administration; emergency department crowding; position statement; throughput; workflow solutions

Indexed keywords

ARTICLE; EMERGENCY CARE; EMERGENCY HEALTH SERVICE; EMERGENCY PHYSICIAN; EMERGENCY WARD; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HOSPITAL MANAGEMENT; PATIENT SATISFACTION; PRIORITY JOURNAL; UNITED STATES;

COMPUTER SIMULATION; CROWDING; EFFICIENCY, ORGANIZATIONAL; EMERGENCY SERVICE, HOSPITAL; HUMANS; TOTAL QUALITY MANAGEMENT; UNITED STATES; WORKFLOW;

EID: 74149090807     PISSN: 07364679     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jemermed.2008.03.038     Document Type: Article

References (48)

1. Derlet R.W., and Richards J.R. Overcrowding in the nation's emergency departments: complex causes and disturbing effects. Ann Emerg Med 35 (2000) 63-68
2. Derlet R., Richards J., and Kravitz R. Frequent overcrowding in U.S. emergency departments. Acad Emerg Med 8 (2001) 151-155
3. Henry M. Overcrowding in America's emergency departments: inpatient wards replace emergency care. Acad Emerg Med 8 (2001) 188-189
4. McCabe J.B. Emergency department overcrowding: a national crisis. Acad Med 76 (2001) 672-674
5. Nourjah P. National Hospital Ambulatory Medical Care Survey: 1997 emergency department summary. Adv Data 304 (1999) 1-24
6. Richards J.R., Navarro M.L., and Derlet R.W. Survey of directors of emergency departments in California on overcrowding. West J Med 172 (2000) 385-388
7. Schneider S., Zwemer F., Doniger A., Dick R., Czapranski T., and Davis E. Rochester, New York: a decade of emergency department overcrowding. Acad Emerg Med 8 (2001) 1044-1050
8. Institute of Medicine. Hospital-based emergency care: at the breaking point (2006), IOM Press, Washington, DC
9. Burt C.W., and McCaig L.F. Trends in hospital emergency department utilization: United States, 1992-99. Vital Health Stat 13 150 (2001) 1-34
10. American College of Emergency Physicians 1998-1999 Safety Net Task Force. Defending America's safety net (1999), American College of Emergency Physicians, Dallas, TX
11. Derlet R.W. Overcrowding in emergency departments: increased demand and decreased capacity. Ann Emerg Med 39 (2002) 430-432
12. Schull M.J., Vermeulen M., Slaughter G., et al. Emergency department crowding and thrombolysis delays in acute myocardial infarction. Ann Emerg Med 11 (2004) 577-585
13. Miro O., Antonio M.T., Jimenez S., et al. Decreased healthcare quality associated with emergency department overcrowding. Eur J Emerg Care 6 (1999) 105-107
14. Pines J.M., Hollander J.E., Localio A.R., and Metlay J.P. The association between ED crowding and hospital performance on antibiotic timing for pneumonia and percutaneous intervention for myocardial infarction. Acad Emerg Med 13 (2006) 873-878
15. Boudreaux E.D., Ary R.D., Mandry C.V., and McCabe B. Determinants of patient satisfaction in a large, municipal ED: the role of demographic variables, visit characteristics, and patient perceptions. Am J Emerg Med 18 (2000) 394-400
16. Kyriacou D.N., Ricketts V., Dyne P.L., McCollough M.D., and Talan D.A. A 5-year time study analysis of emergency department patient care efficiency. Ann Emerg Med 34 (1999) 326-335
17. Sun B.C., Adams J., Orav E.J., Rucker D.W., Brennan T.A., and Burstin H.R. Determinants of patient satisfaction and willingness to return with emergency care. Ann Emerg Med 35 (2000) 426-434
18. Bursch B., Beezy J., and Shaw R. Emergency department satisfaction: what matters most?. Ann Emerg Med 22 (1993) 586-591
19. Watson W.T., Marshall E.S., and Fosbinder D. Elderly patients' perceptions of care in the emergency department. J Emerg Nurs 25 (1999) 88-92
20. Hobbs D., Kunzman S.C., Tandberg D., and Sklar D. Hospital factors associated with emergency center patients leaving without being seen. Am J Emerg Med 18 (2000) 767-772
21. Emergency department cycle time survey 2004 (2004), University Health Consortium, Oak Brook, IL
22. US General Accounting Office. Hospital emergency departments. crowded conditions vary among hospitals and communities (2003), General Accounting Office, Washington, DC
23. US General Accounting Office. Emergency departments: unevenly affected by growth and change in patient use: 1993. http://161.203.16.4/d36t11/148331.pdf Accessed August 30, 2004
24. th edn. (2005), McGraw-Hill, New York
25. th edn. (2006), McGraw-Hill, Boston
26. rd edn. (2004), North River Press, Great Barrington, MA
27. Solberg L.I., Asplin B.R., Wienick R.M., and Magid D.J. Emergency department crowding: consensus development of potential measures. Ann Emerg Med 42 (2003) 824-834
28. Lattimer V., George S., Thompson F., et al. Safety and effectiveness of nurse telephone consultation in out of hours primary care: randomized controlled trial. BMJ 317 (1998) 1054-1059
29. McGarvey R.N., and Harper J.J. Pneumonia mortality reduction and quality improvement in a community hospital. Qual Rev Bull 19 (1993) 124-130
30. McFadden E.R., Elsanadi N., Dixon L., et al. Protocol therapy for acute asthma: therapeutic benefits and cost savings. Am J Med 99 (1995) 651-661
31. The emergency severity index, version 4. everything you need to know. (DVD set: publication no. 05-0046-DVD); emergency severity index, version 4: implementation handbook (publication no. 05-0046-2). http://www.ahrq.gov/research/esi
32. ED's paradigm shift cuts costs, improves quality. Health Benchmarks 4 (1997) 65-66 75-7
33. Trudeau S., and Ladue M. Wireless bedside registration in the emergency department. J Emerg Nurs 22 (1996) 57-60
34. Switching to bedside registration increases patient satisfaction. ED Manag 9 (1997) 25-30
35. Rhee K.J., and Bird J. Perceptions and satisfaction with emergency department care. J Emerg Med 14 (1996) 679-683
36. Spaite D.W., Bartholomeaux F., Guisto J., et al. Rapid process redesign in a university-based emergency department: decreasing waiting time intervals and improving patient satisfaction. Ann Emerg Med 39 (2002) 168-177
37. Malvehy M.A., Chansky M., Killian A., et al. The effects of bedside registration on emergency department patient care time intervals. Acad Emerg Med 9 (2002) 510
38. George M.L. Lean Six Sigma for service: how to use Lean speed and Six Sigma quality to improve services and transactions (2003), McGraw-Hill, New York
39. George M.L., Rowlands D.T., Price M., and Maxey J. The Lean Six Sigma pocket toolbook (2005), McGraw-Hill, New York
40. Aldarrab A. Application of Lean Six Sigma for patients presenting with ST-elevation myocardial infarction: the Hamilton Health Sciences experience. Healthc Q 9 (2006) 56-61
41. Fairbanks C.B. Using Six Sigma and Lean methodologies to improve OR throughput. AORN J 86 (2007) 73-82
42. de Koning H., Verver J.P., van den Heuvel J., et al. Lean Six Sigma for healthcare. J Healthc Qual 28 (2006) 4-11
43. Sunyog M. Lean management and Six-Sigma yield big gains in hospital's immediate response laboratory. Quality improvement techniques save more than $400,000. Clin Leadersh Manag Rev 18 (2004) 255-258
44. Caldwell C., Brexler J., and Gillem T. Lean Six Sigma for healthcare (2005), Productivity Press, New York
45. Brassard M., and Ritter D. Sailing through Six Sigma (2002), Brassard & Ritter, LLC, Marietta, GA
46. nd edn. (2003), Southwestern College Publishing, Cincinnati, OH
47. Statistical forecasting demonstration. www.forecastpro.com Accessed May 1, 2008
48. Kaplan R.S., and Norton D.P. The balanced scorecard: translating strategy into action (1996), arvard Business School, Cambridge, MA