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Emergency Department Holding Orders.

Stephen J Traub1, M'Hamed Temkit2, Soroush Saghafian3

  • 1Department of Emergency Medicine, Mayo Clinic Arizona, Phoenix, Arizona; College of Medicine, Mayo Clinic, Rochester, Minnesota.

The Journal of Emergency Medicine
|March 11, 2017
PubMed
Summary
This summary is machine-generated.

Emergency department (ED) holding orders improve patient flow and reduce length of stay without increasing undertriage or overtriage. This study supports their use for safe and effective ED throughput enhancement.

Keywords:
holding orderslength of staythroughput

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Area of Science:

  • Emergency Medicine
  • Healthcare Management
  • Patient Flow Optimization

Background:

  • Holding orders are utilized to facilitate the transition of admitted emergency department (ED) patients to inpatient hospital beds.
  • Effective management of ED patient flow is crucial for hospital operations and patient care.

Purpose of the Study:

  • To investigate the impact of ED holding orders on patient flow metrics.
  • To assess the safety and efficiency of ED holding orders in a hospital setting.

Main Methods:

  • A retrospective study analyzed 9501 ward admissions from the ED over two years.
  • Patients were categorized based on the presence and type of ED holding orders.
  • Outcomes included ED length of stay (LOS), time from decision to admit to ED departure (D→D), potential undertriage, and potential overtriage.

Main Results:

  • ED holding orders (group 1) were associated with a significant reduction in mean ED LOS compared to no holding orders (group 2) (44 min reduction).
  • Specific order types showed varying LOS improvements: group 1A (ED orders only) vs. group 1B (subsequent HIM orders) had a 48 min reduction.
  • No increase in potential undertriage or overtriage was observed with the use of holding orders.

Conclusions:

  • ED holding orders are linked to enhanced ED throughput and improved patient flow.
  • The implementation of ED holding orders is a safe and effective strategy for optimizing ED operations.