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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Published on: January 15, 2017

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Improving Safety and Quality With an Emergency Department Overcrowding Plan

Addison Watson, Wilma Powell Stuart

    Journal of Emergency Nursing
    |July 6, 2023
    PubMed

    Insights

    Implementing a revised emergency department overcrowding plan significantly reduced patient wait times and length of stay. This initiative improved patient safety and healthcare system efficiency by decreasing left-without-being-seen rates and overall overcrowding.

    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.
    Abstract

    Keywords:
    Ambulance diversionCrowdingHospital emergency serviceQuality improvementSurge capacity

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