Managing the storm: an emergency department capacity strategy

This article assesses the extent to which a team using quality improvement methods could improve the timeliness of the flow of admitted patients through the emergency department in one hospital. Using a structured approach, a multidisciplinary team redesigned the processes for admitting patients from the emergency department to the inpatient unit. Indicators of capacity limitations in the inpatient environment were also identified as triggers for a tiered institutional response to capacity constraints. Three time intervals in the admission process were identified for measuring performance, with comparisons to the same months of the previous year to determine significance. Significant reductions in the median minutes for a majority of the time intervals studied were achieved during the 6-month study period. The data from the study suggest that improvements in patient progression through an emergency department can be achieved with quality improvement methods. Success factors for this and other improvement strategies are discussed.