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Related Concept Videos

Methods of Documentation VII: EMR01:30

Methods of Documentation VII: EMR

Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare settings,...
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Clinical Application of Phase Angle and BIVA Z-Score Analyses in Patients Admitted to an Emergency Department with Acute Heart Failure
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Volume-related differences in emergency department performance.

Shari J Welch1, James J Augustine, Li Dong

  • 1Institute for Health Care Delivery Research, Intermountain Healthcare, Salt Lake City, Utah, USA. sharijwelch@gmail.com

Joint Commission Journal on Quality and Patient Safety
|September 26, 2012
PubMed
Summary

Higher emergency department (ED) volume correlates with poorer operational performance, including longer wait times and higher left-without-being-seen rates. Acuity also impacts performance metrics.

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Area of Science:

  • Emergency Medicine
  • Healthcare Operations Research

Background:

  • Emergency departments (EDs) are critical access points for over 136 million US visits annually, with over half of hospital admissions originating in the ED.
  • The Joint Commission's patient flow standards necessitate the measurement and monitoring of emergency department performance.
  • A study investigated the relationship between ED volume, operating characteristics, and performance metrics.

Purpose of the Study:

  • To correlate emergency department (ED) volume and operating characteristics with performance on key metrics.
  • To identify predictors of operational performance in emergency departments.
  • To inform ED design, operations, and policy decisions.

Main Methods:

  • Retrospective analysis of the 2009 Emergency Department Benchmarking Alliance (EDBA) annual survey data.
  • Utilized data from 358 hospitals representing 14.6 million ED visits.
  • Ensured ED size representation approximated the Emergency Medicine Network (EM Net).

Main Results:

  • Larger EDs with higher annual volumes demonstrated significantly poorer performance: longer lengths of stay (p < .0001), higher left-without-being-seen rates (p < .0001), and longer door-to-physician times (p < .0001).
  • Operating characteristics indicating higher patient acuity were associated with worsened performance metrics.
  • Characteristics indicating lower acuity were associated with improved performance.

Conclusions:

  • Emergency department (ED) volume is the strongest predictor of operational performance and can be used for comparative analysis.
  • Patient acuity and other operating characteristics also significantly influence ED performance.
  • Performance measures should incorporate ED volume, acuity, and other factors for accurate assessment and to guide improvements in ED design and operations.