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Retrospective analysis of quality improvement throughput measures at a high-volume community emergency department.
J Healthc Qual. 2014 Sep-Oct; 36(5):13-25.JH

Abstract

OBJECTIVE

To assess the effect of having a physician or physician's assistant (PA) as patients' first point of contact in our emergency department (ED) on the rate of leaving without being seen (LWBS) and wait time.

METHODS

In before and after intervention conducted in the ED at a 265-bed community hospital, data were collected on all patients presenting to the ED during a 70-month period. A physician or PA was stationed in triage 16 hr a day. The screening process included measurement of vital signs, a brief history and physical examination, and computerized physician order entry.

RESULTS

During the study period, volume increased from 86,000 to 102,000 patients per year. Monthly averages for ED visits increased 16%, admissions increased 5%, and ambulance visits increased 18%. The rate of LWBS decreased from 3.1% to 1.7%. Door-to-doctor time decreased by 14 min.

CONCLUSIONS

Despite an increase in patient census, the LWBS rate and door-to-doctor time decreased. This study of one solution to the issue of ED crowding demonstrates how a process redesign can lead to successful changes in throughput metrics.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23731214

Citation

Milsten, Andrew, et al. "Retrospective Analysis of Quality Improvement Throughput Measures at a High-volume Community Emergency Department." Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality, vol. 36, no. 5, 2014, pp. 13-25.
Milsten A, Klein J, Liu Q, et al. Retrospective analysis of quality improvement throughput measures at a high-volume community emergency department. J Healthc Qual. 2014;36(5):13-25.
Milsten, A., Klein, J., Liu, Q., Vibhakar, N., & Linder, L. (2014). Retrospective analysis of quality improvement throughput measures at a high-volume community emergency department. Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality, 36(5), 13-25. https://doi.org/10.1111/jhq.12014
Milsten A, et al. Retrospective Analysis of Quality Improvement Throughput Measures at a High-volume Community Emergency Department. J Healthc Qual. 2014 Sep-Oct;36(5):13-25. PubMed PMID: 23731214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrospective analysis of quality improvement throughput measures at a high-volume community emergency department. AU - Milsten,Andrew, AU - Klein,Joel, AU - Liu,Qin, AU - Vibhakar,Neel, AU - Linder,Lawrence, Y1 - 2013/06/03/ PY - 2013/6/5/entrez PY - 2013/6/5/pubmed PY - 2015/4/14/medline KW - ED throughput KW - crowding KW - physician triage SP - 13 EP - 25 JF - Journal for healthcare quality : official publication of the National Association for Healthcare Quality JO - J Healthc Qual VL - 36 IS - 5 N2 - OBJECTIVE: To assess the effect of having a physician or physician's assistant (PA) as patients' first point of contact in our emergency department (ED) on the rate of leaving without being seen (LWBS) and wait time. METHODS: In before and after intervention conducted in the ED at a 265-bed community hospital, data were collected on all patients presenting to the ED during a 70-month period. A physician or PA was stationed in triage 16 hr a day. The screening process included measurement of vital signs, a brief history and physical examination, and computerized physician order entry. RESULTS: During the study period, volume increased from 86,000 to 102,000 patients per year. Monthly averages for ED visits increased 16%, admissions increased 5%, and ambulance visits increased 18%. The rate of LWBS decreased from 3.1% to 1.7%. Door-to-doctor time decreased by 14 min. CONCLUSIONS: Despite an increase in patient census, the LWBS rate and door-to-doctor time decreased. This study of one solution to the issue of ED crowding demonstrates how a process redesign can lead to successful changes in throughput metrics. SN - 1945-1474 UR - https://www.unboundmedicine.com/medline/citation/23731214/Retrospective_analysis_of_quality_improvement_throughput_measures_at_a_high_volume_community_emergency_department_ L2 - https://doi.org/10.1111/jhq.12014 DB - PRIME DP - Unbound Medicine ER -