Improving the wait time to consultation at the emergency department

Area of Science:

• Healthcare Management
• Clinical Operations
• Quality Improvement

Background:

• Prolonged emergency department (ED) wait times are linked to adverse patient outcomes and reduced satisfaction.
• Effectively reducing ED wait times to consultation (WTC) presents a significant operational challenge.

Purpose of the Study:

• To assess the impact of implementing specific interventions on decreasing ED wait time to consultation (WTC) within a six-month period.
• To evaluate the sustainability and consistency of improvements in ED WTC.

Main Methods:

• A retrospective analysis established baseline ED WTC from January 2015 to May 2016.
• Rapid Plan-Do-Study-Act (PDSA) cycles were employed to implement interventions including a common work output board, manpower adjustment to patient arrivals, and a team-based care model.
• Changes in WTC were monitored alongside patient volume, staffing, and admission rates from October 2016 to April 2017.

Main Results:

• The average 95th percentile WTC decreased by 38 minutes, from 162 to 124 minutes.
• Median WTC improved from 24 minutes to 21 minutes.
• These improvements were sustained despite a 7% increase in monthly patient load and without changes in ED manpower or admissions.

Conclusions:

• Low-cost interventions focused on transparency, equitable workload distribution, and team-based care models can effectively reduce ED wait times.
• A data-driven quality improvement approach, supported by senior clinicians and continuous feedback, ensures sustained improvements in ED operational efficiency.