A Full-Capacity Protocol Allows for Increased Emergency Patient Volume and Hospital Admissions.

Area of Science:

• Emergency Medicine
• Healthcare Management
• Quality Improvement

Background:

• Hospitals frequently face emergency department (ED) crowding, impacting patient care and operational efficiency.
• A collaborative full-capacity protocol was developed to address anticipated or actual ED crowding conditions.

Purpose of the Study:

• To evaluate the impact of implementing a hospital-wide full-capacity protocol on key emergency department performance metrics.
• To assess the protocol's effectiveness in managing increased patient volumes and hospital admissions.

Main Methods:

• A quality improvement initiative was conducted using a pre/post analysis of ED patient encounters.
• Data from the post-full-capacity protocol period were compared to a corresponding period from the prior year.
• Key outcomes included patient volume, admission rates, left without being seen (LWBS) rates, length of stay, and ambulance diversion hours.

Main Results:

• A 7.4% increase in emergency patient encounters and an 11.9% increase in admissions were observed post-protocol implementation.
• The left without being seen (LWBS) rate decreased by 10.2%.
• Ambulance diversion hours decreased by 92% (111 fewer hours), despite a 34-minute increase in average length of stay.

Conclusions:

• The collaborative full-capacity protocol proved effective in mitigating emergency department crowding.
• The protocol successfully reduced patient left without being seen rates and ambulance diversion.
• It demonstrated the capacity to manage a significant rise in ED patient volume and hospital admissions.