Lost bed capacity in emergency departments: A descriptive analysis and data visualisation exploration.

Area of Science:

• Emergency Medicine
• Healthcare Operations Research
• Health Informatics

Background:

• Optimizing emergency department (ED) bed resource utilization is critical for patient flow.
• Understanding the duration of patient stays post-emergency care is essential for identifying bottlenecks.

Purpose of the Study:

• To map ED bed utilization over time.
• To quantify the proportion of patient stay dedicated to non-emergent care.
• To develop visualizations for effective bed utilization analysis.

Main Methods:

• Retrospective cohort study using electronic health record data from a tertiary ED.
• Analysis focused on patients in the acute care area over a 1-month period.
• Lost Bed Capacity (LBC) defined as time in bed after emergency care completion.

Main Results:

• 38.5% of ED bed time occurred after emergency care was completed.
• LBC varied significantly by disposition: 1 min for discharged, 72 min for admitted-ward, and 110 min for admitted-critical care.
• Novel LBC heatmaps effectively visualized these utilization patterns.

Conclusions:

• A substantial amount of ED length of stay is attributable to patients occupying beds post-emergency care.
• Reducing LBC, particularly for admitted patients, can significantly decrease overall ED length of stay.
• LBC heatmaps offer a potentially automated and intuitive tool for analyzing ED patient flow issues.