Implementation of Vertical Split Flow Model for Patient Throughput at a Community Hospital Emergency Department

Area of Science:

• Emergency Medicine
• Healthcare Management
• Patient Flow Optimization

Background:

• Hospitals face overcrowding challenges in emergency departments (EDs).
• Vertical split flow is an innovative strategy assigning patients to chairs based on acuity, optimizing patient flow.
• This approach aims to alleviate ED overcrowding by rethinking patient placement.

Purpose of the Study:

• To evaluate the impact of vertical split flow implementation on Emergency Severity Index (ESI) level 3 patients.
• Assessed effects on patient length of stay and throughput in a community hospital ED.
• Determined the efficacy of vertical split flow in managing ED patient flow.

Main Methods:

• Retrospective cohort study design.
• Included all ESI level 3 patients at a community hospital ED.
• Data collected over a 3-month period before and after vertical split flow implementation (2018-2019).

Main Results:

• Analyzed 10,638 patient visits (5262 pre-intervention, 5376 post-intervention).
• Mean length of stay for ESI-3 patients significantly reduced from 283 minutes to 251 minutes (p < 0.001).
• Vertical split flow demonstrated a positive impact on patient throughput.

Conclusions:

• Vertical split flow implementation for ESI level 3 patients significantly reduced overall length of stay.
• The strategy improved patient throughput in the community hospital ED.
• This model offers a solution to increase ED capacity without additional staffing or space.