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Unnecessary wait hours: a novel ED system-level metric
Heather A Heaton1, David M Nestler2, Kalyan S Pasupathy3
1Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA heaton.heather@mayo.edu.
Emergency Medicine Journal : EMJ
|June 24, 2020
Summary
Introducing the Number of Unnecessary Waits (NUW) metric to assess emergency department (ED) space efficiency. This metric revealed that a dedicated flow clinical technician assistant (CTA) role reduced unnecessary wait hours, even with increased patient volumes.
Area of Science:
- Healthcare Operations Research
- Emergency Medicine Management
- Health Systems Engineering
Background:
- Emergency department (ED) leaders face pressure to enhance care delivery efficiency.
- Traditional ED efficiency metrics are patient-centered and miss facility-based improvement opportunities.
- Novel metrics are needed to evaluate space utilization and operational flow within EDs.
Purpose of the Study:
- To introduce and evaluate the Number of Unnecessary Waits (NUW) and Unnecessary Wait Hours (UWH) metrics for measuring ED space efficiency.
- To assess the impact of a newly created flow clinical technician assistant (CTA) role on ED operational efficiency using the NUW metric.
Main Methods:
- Developed the Unnecessary Wait Hours (UWH) metric, quantifying unnecessary patient waits based on room availability and patient census.
- Retrospectively analyzed 3.5 months of ED operational data before and after the implementation of a flow CTA.
- Applied the NUW metric to evaluate changes in space efficiency attributed to the flow CTA role.
Main Results:
- The NUW metric indicated that the implementation of a flow CTA role led to a decrease in unnecessary wait hours.
- Analysis showed that increased patient volumes had a counteracting effect, potentially increasing wait times.
- The study demonstrated the utility of the NUW metric in identifying operational improvements.
Conclusions:
- System-level metrics, such as NUW, offer a new perspective for evaluating ED operational efficiencies beyond patient-centered measures.
- Further research is needed to understand the role and impact of system-level metrics in assessing ED performance.
- Implementing specialized roles like the flow CTA can positively influence ED efficiency and patient flow.
Keywords:
emergency department
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