The effect of vertical split-flow patient management on emergency department throughput and efficiency
2018
The American Journal of Emergency Medicine
Journal Article
Issue 9
Volume 36
Pages 1581-1584
Author(s): Garrett, J. S., Berry, C., Wong, H., Qin, H., Kline, J. A.
In some emergency departments (EDs), the severity of a patient’s condition is rated on a 5-point scale during admission using the Emergency Service Index (ESI). Under the “split-flow” model of patient triaging, patients with less-severe conditions (rated an ESI 4 or 5) are “fast tracked” so that they can be separated from patients with higher ESI scores, allowing for more efficient resource allocation for all patient treatment procedures.
Added December 2018
Introduction of a horizontal and vertical split flow model of emergency department patients as a response to overcrowding
2018
Journal of Emergency Nursing
Journal Article
Issue 4
Volume 44
Pages 345-352
Author(s): Wallingford, G., Joshi, N., Callagy, P., Stone, J., Brown, I., Shen, S.
Hospital emergency departments (EDs) strive to optimally organize patient flow so that optimal care can be delivered while patient length of stay is minimized. The emergency severity index (ESI) is a 5-point scale used to help medical staff discern the severity of patient conditions; higher ESI scores indicate less-severe medical conditions.
Added December 2018
Deliberate Perioperative Systems Design Improves Operating Room Throughput
2005
Anesthesiology: The Journal of the American Society of Anesthesiologists
Journal Article
Issue 2
Volume 103
Pages 406-418
Author(s): Sandberg, W. S., Daily, B., Egan, M., Stahl, J. E., Goldman, J. M., Wiklund, R. A., Rattner, D.
Operating rooms (ORs) are complex and sensitive environments that are typically expensive to operate and maintain. Minimally invasive surgical procedures are becoming increasingly more prevalent in many OR environments, while the costs of operating and maintaining OR environments are simultaneously increasing.
Added November 2018
Separate Medication Preparation Rooms Reduce Interruptions and Medication Errors in the Hospital Setting: A Prospective Observational Study
2016
Journal of Patient Safety
Journal Article
Issue 3
Volume 17
Pages e161-e168
Author(s): Huckels-Baumgart, S., Baumgart, A., Buschmann, U., Schüpfer, G., Manser, T.
Errors and interruptions are commonplace during medication preparation procedures in healthcare environments. One study found that one interruption occurred for every 3.2 drugs administered during nurses’ medication rounds.
Added December 2016
"Let's Sit Forward": Investigating Interprofessional Communication, Collaboration, Professional Roles, and Physical Space at EmergiCare
2016
Health Communication
Journal Article
Issue 12
Volume 31
Pages 1506-1516
Author(s): Dean, M., Gill, R., Barbour, J. B.
Due to the fact that emergency department (ED) caregivers are constantly involved in interprofessional, knowledge-intensive conversations, effective modes of communication necessarily play a key role in promoting patient health and safety. Previous studies have explored how the physical environment directly affects modes of communication, and how these two dimensions of the healthcare environment constantly intersect with each other.
Added August 2016
Healthcare Staffs’ Experiences and Perceptions of Caring for People with Dementia in the Acute Setting: Qualitative Evidence Synthesis
2016
International Journal of Nursing Studies
Journal Article
Author(s): Houghton, C., Murphy, K., Brooker, D., Casey, D.
Dementia is an international health issue that greatly impacts healthcare delivery systems. Individuals with dementia have specific needs when it comes to healthcare, and it seems that, generally, acute care environments aren’t suitable for these individuals. Considering how previous studies have shown that as much as a quarter of individuals utilizing acute hospital services are likely to have dementia, the authors posit that there needs to be a shift in ethos, organization, and environment in which more appropriate care is provided to patients with dementia in acute care settings.
Added June 2016
Understanding Green Building Design and Healthcare Outcomes: Evidence-Based Design Analysis of an Oncology Unit
2016
Journal of Architectural Engineering
Journal Article
Author(s): Campion, N., Thiel, C. L., Focareta, J., Bilec, M. M.
The United States healthcare industry is a major part of the economy as well as a significant contributor to carbon dioxide emissions and other environmental issues. Green building design (GBD) attempts to offset environmental impacts of buildings, and recently designers have been combining GBD with evidence-based design (EBD) in order to create facilities that positively impact both the external and internal environment.
Added June 2016
Impact of the Physical Environment of Residential Health, Care, and Support Facilities (RHCSF) on Staff and Residents A Systematic Review of the Literature
2015
Environment and Behavior
Journal Article
Issue 10
Volume 48
Pages 1203-1241
Author(s): Joseph, A., Choi, Y.-S., Quan, X.
Strategies related to the design of the built environment should be considered within the context of the culture of the organization and the resident population. This study of the physical environment of residential health, care, and support facilities addresses the range of settings and population, where other studies have been lacking. The literature review strongly suggests that the built environment is an important component of care provided in residential care settings.
Added May 2016
Adapting to Family-Centered Hospital Design: Changes in Providers’ Attitudes over a Two-Year Period
2009
Health Environments Research & Design Journal
Journal Article
Issue 1
Volume 3
Pages 79-96
Author(s): France, D., Throop, P., Joers, B., Allen, L., Parekh, A., Rickard, D., Deshpande, J.
Although hospitals are being designed based on evidence-based design principles, it’s unclear how working in such an environment influences providers’ attitudes and professional performance.
Added January 2016
Leading Change During an Inpatient Critical Care Unit Expansion
2008
Journal of Nursing Administration
Journal Article
Issue 11
Volume 38
Pages 461-467
Author(s): Braungardt, T. & Fought, S. G.
Acute care hospitals are changing rapidly to address economic and technologic advancements and meet community needs. The authors describe one medical center’s use of Kotter’s work on leading change to expand the neuroscience intensive care unit from 10 to 30 beds to meet community needs, improve hospital efficiencies, and increase bed capacity.
Added January 2016
Measuring the Use of Examination Room Time in Oncology Clinics: A Novel Approach to Assessing Clinic Efficiency and Patient Flow
2014
Journal of Oncology Practice
Journal Article
Author(s): Hamel, L. M., Chapman, R., Eggly, S., Penner, L. A., Tkatch, R., Vichich, J., Albrecht, T. L.
Inefficient use of time can drain resources and impede effective clinic flow. Long wait times in oncology units often result in higher costs for both caregivers and patients, while patients also tend to experience increased stress and reduced overall satisfaction with their treatment. Long wait times have also been shown to directly and indirectly reduce patient adherence to recommended treatments.
Added December 2015
The Impact of a Flexible Care Area on Throughput Measures in an Academic Emergency Department
2015
Journal of Emergency Nursing
Journal Article
Issue 6
Volume 41
Pages 503-509
Author(s): McGrath, J., LeGare, A., Hermanson, L., Repplinger, M. D.
This paper explores the implementation of a novel strategy which involved the creation of a “flexible care area” (FCA), a space designed for initiating patient evaluations and treatments at the beginning of a patient’s visit.
Added December 2015
Initiatives to reduce overcrowding and access block in Australian emergency departments: A literature review
2014
Collegian
Journal Article
Issue 4
Volume 21
Pages 359-366
Author(s): Crawford, K., Morphet, J., Jones, T., Innes, K., Griffiths, D., Williams, Allison
Australian emergency departments are experiencing an increasing demand for their services. Patient throughput continues to expand resulting in overcrowding and access block where patients cannot gain entry to appropriate hospital beds. This is despite both state and federal governments implementing numerous schemes to address the complex causes of stress on emergency departments. This paper...
Added December 2015
Using Lean-Based Systems Engineering to Increase Capacity in the Emergency Department
2014
Western Journal of Emergency Medicine
Journal Article
Issue 7
Volume 15
Pages 770-776
Author(s): White, B., Chang, Y., Grabowski, B., Brown, D.
Emergency department (ED) crowding is a widespread issue that causes a multitude of negative effects on patient care quality, safety, and efficiency. Lean-based systems engineering, which is often used for industrial manufacturing, is a method for eliminating all forms of waste (including wasted time and other resources) to optimize productivity. Recent studies have begun to demonstrate the use of systems engineering and improvement science on streamlining processes and improving throughput in different medical capacities, but an opportunity remains to refine the application of these tools within EDs in particular.
Added December 2015
Physical Design Correlates of Efficiency and Safety in Emergency Departments: A Qualitative Examination
2014
Critical Care Nursing Quarterly
Journal Article
Issue 3
Volume 37
Pages 299-316
Author(s): Pati, D., Harvey, T. E., Pati, S.
The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multimeasure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site.
Added November 2015
Emergency department observation units: A clinical and financial benefit for hospitals
2011
Health Care Management Review
Journal Article
Issue 1
Volume 36
Pages 28-37
Author(s): Baugh, C.W., Venkatesh, A. K., Bohan, J. S.
This article presents a review of literature to make a clinical and business case for establishing EDOUs. The literature was found to indicate that EDOU care contributes to more effective clinical decision-making and the generation of higher revenue than the same patients would if admitted and then discharged.
Added March 2015
The effects of physical environments in medical wards on medication communication processes affecting patient safety
2014
Health & Place
Journal Article
Author(s): Liu, W., Manias, E., Gerdtz, M.
The physical environment of a hospital has a wide range of effects on the quality of care administered to patients. In the context of medication distribution, seamless communication among healthcare professionals of different backgrounds is imperative, and in many cases the physical environment itself can have positive or negative effects on this complex process.
Added November 2014
Intra-unit patient transports: time, motion, and cost impact on hospital efficiency
2005
Nursing Economic$
Journal Article
Issue 4
Volume 23
Pages 157-164
Author(s): Hendrich, A. L., Lee, N.
Transferring patients can be stressful and confusing for patients and their families. In addition, risks to the patient increase during transfers. Thus, many healthcare facilities are trying to reduce patient transfers by providing more flexible patient rooms.
Added May 2014
Environmental evaluation for workplace violence in healthcare and social services
2008
Journal of Safety Research
Journal Article
Issue 2
Volume 39
Pages 237-50
Author(s): McPhaul, K.M. , Murrett, K., Flannery, K. , Rosen, J., Lipscomb, J., London, M.
The purpose of this project was to contribute specific, evidence–based guidance to the healthcare and social services employer communities regarding the use of environmental design to prevent violence.
Added April 2014
Challenges in Design and Transition to a Private Room Model in the Neonatal Intensive Care Unit
2006
Advances in Neonatal Care
Journal Article
Issue 5
Volume 6
Pages 271-280
Author(s): Carlson, B., Walsh, S., Wergin, T., Schwarzkopf, K., Ecklund, S.
The need for neonatal intensive care units (NICU) is increasing at a time when research suggests their designs need to change to provide a developmentally appropriate healing environment. One approach is a private room NICU model versus a large multibed ward. However, such a radical design change could be challenging to implement.
Added April 2014
