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Updated: Dec 27, 2025

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Using emergency physicians' abilities to predict patient admission to decrease admission delay time.

Erica E M Lee1, Edmund S H Kwok2, Christian Vaillancourt2,3

  • 1Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada ericlee@toh.ca.

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PubMed
Summary
This summary is machine-generated.

Emergency physicians (EPs) can accurately predict patient admissions, potentially saving significant emergency department (ED) stretcher time. Initiating bed requests with consultations could reduce ED crowding and improve patient flow.

Keywords:
admission avoidanceemergency departmenthospitalisations

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Area of Science:

  • Emergency Medicine
  • Healthcare Management
  • Patient Flow Optimization

Background:

  • Emergency departments (EDs) face crowding due to delays in patient admissions.
  • Emergency physicians (EPs) often lack admitting privileges, necessitating consultant assessments before bed requests.
  • This process prolongs ED stays and exacerbates crowding.

Purpose of the Study:

  • To measure EPs' accuracy in predicting patient admissions before consultation.
  • To estimate the potential ED stretcher time saved by initiating bed requests concurrently with consultations.

Main Methods:

  • Prospective cohort study in a Canadian academic center (Oct 2017-Feb 2018).
  • Included ED patients requiring consultation, excluding critical cases and minors.
  • EPs predicted admission status pre-consultation; time savings were calculated based on predicted admissions.

Main Results:

  • Study included 454 patients (mean age 60.1, 48.5% male); 69.4% were admitted.
  • EPs demonstrated high predictive accuracy: 90.5% sensitivity, 84.2% specificity.
  • An estimated 922.1 hours of ED stretcher time could have been saved during the study period.

Conclusions:

  • EP-initiated hospital admissions can significantly decrease ED waiting times.
  • Implementing this strategy can alleviate ED crowding globally.
  • Streamlining the admission process improves overall healthcare efficiency.