Improving Safety and Quality With an Emergency Department Overcrowding Plan

Area of Science:

• Healthcare Management
• Quality Improvement
• Emergency Medicine

Background:

• Emergency department overcrowding is a persistent global issue impacting patient care quality and safety.
• Strategies to mitigate overcrowding focus on reducing wait times, left-without-being-seen rates, and length of stay.

Purpose of the Study:

• To revise and strengthen an emergency department overcrowding plan using an interdisciplinary team.
• Objectives included reducing patient wait times, length of stay, and left-without-being-seen rates.

Main Methods:

• An interprofessional quality improvement team collaborated to enhance the emergency response plan.
• Key interventions included automating an overcrowding measurement tool, developing a tiered response plan, and implementing a standardized multidisciplinary paging protocol.

Main Results:

• The revised plan led to a 2.7% decrease in left-without-being-seen rates.
• Median emergency department length of stay decreased by 42 minutes (14.5%).
• Daily overcrowding decreased by 3.56 hours (33.3%).

Conclusions:

• Effective emergency department overcrowding plans are crucial for patient quality, safety, and health system planning.
• An efficient plan leverages system-wide resources to manage fluctuating patient census and acuity.
• This study demonstrates the value of a structured, interdisciplinary approach to managing emergency department overcrowding.