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Emergency Department Length of Stay: A Community Hospital Initiative.

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|August 2, 2024
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Summary

Implementing a provider in triage and a split flow model significantly decreased emergency department (ED) length of stay (LOS) for discharged patients. This quality improvement initiative enhanced patient care efficiency in a community hospital setting.

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Area of Science:

  • Emergency Medicine
  • Healthcare Management
  • Quality Improvement

Background:

  • Extended emergency department (ED) length of stay (LOS) negatively impacts patient care, satisfaction, and hospital revenue.
  • A provider in triage and a split flow model offers a potential solution to improve ED throughput and reduce LOS.

Purpose of the Study:

  • To evaluate the effectiveness of a provider in triage and split flow model in reducing the LOS for discharged patients in a community hospital ED.
  • To assess the impact of this model on key ED performance metrics.

Main Methods:

  • A quality improvement initiative utilized the Plan-Do-Study-Act (PDSA) cycle.
  • A provider was integrated into the triage process, and a split flow system was implemented to manage lower acuity patients (ESI levels 3 and 4) separately.
  • Key metrics including arrival to provider time, arrival to bed time, and LOS were compared before and after implementation.

Main Results:

  • The provider in triage and split flow model demonstrated a significant reduction in the LOS for discharged patients.
  • Key performance indicators such as arrival to triage, arrival to bed, and arrival to provider times were substantially improved.

Conclusions:

  • The implementation of a provider in triage and a split flow model is effective in decreasing ED LOS for discharged patients.
  • This model enhances overall ED efficiencies and improves the quality of patient care within a community hospital setting.