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Reduced access block causes shorter emergency department waiting times: An historical control observational study
1Emergency Department, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia. rdunn@mail.rah.sa.gov.au
Objective:
To study the effect of changes in hospital occupancy and ED occupancy on ED waiting times during a 13-day period of improved bed access.
Methods:
A comparative, observational study of 1133 ED attendances in the study period and 2332 attendances in a historical control period.
Results:
During the study period, mean hospital occupancy decreased from 94.9% to 89.0% (P < 0.001), mean ED occupancy decreased from 19.1 to 14.8 patients (P < 0.001) and the mean ED waiting time decreased from 58.5 to 37.1 min (P < 0.001). There were statistically significant reductions in waiting times for patients in Australasian triage scale (ATS) categories 2-5. Departmental staffing levels, attendances and patient acuity were not significantly different during the study and control periods.
Conclusions:
Modest decreases in hospital occupancy resulted in highly significant reductions in ED waiting times. Emergency department overcrowding due to large numbers of admitted patients awaiting hospital admission is a major cause of ED dysfunction.