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Knowledge Repository

A complete, user-friendly database of healthcare design research references MoreLess about the Knowledge Repository

The Knowledge Repository is a complete, user-friendly database of healthcare design research references that continues to grow with the latest peer-reviewed publications. Start with our Knowledge Repository for all of your searches for articles and research citations on healthcare design topics. Access full texts through the source link, read key point summaries, or watch slidecasts. Expand your search and find project briefs, interviews, and other relevant resources by visiting our Insights & Solutions page.


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Displaying 1 - 17 of 17

Analysis of functional layout in emergency departments (ED). Shedding light on the free standing emergency department (FSED) model

Author(s): Brambilla, A., Mangili, S., Das, M., Lal, S., Capolongo, S.
Research shows that emergency departments (EDs) are facing overcrowding, increasing patient acuity, and short staffing, which all are impacting wait times to be seen and patient satisfaction scores.
Key Point Summary
Added December 2022

Leveraging discrete event simulation modeling to evaluate design and process improvements of an emergency department

Author(s): Zamani, Z.
Research shows that emergency departments (EDs) are frequently challenged by high patient volumes, unpredictable surges, and emergency care providers who may be at increased risk for burnout and mental distress. Furthermore, longer wait times have been associated with an increased potential for adverse events and patient mortality.
Key Point Summary
Added December 2022

The impact of the healthcare environment on patient experience in the emergency department: A systematic review to understand the implications for patient-centered design

Author(s): Rowe, A, Knox, M.
Research shows that emergency departments (EDs) continue to be undersized, understaffed, and challenged with operational issues that cause decreased patient and provider satisfaction. The ED is at times the initial point of contact for a patient with the healthcare system and may be their first hospital experience
Key Point Summary
Added December 2022

The effect of vertical split-flow patient management on emergency department throughput and efficiency

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.
Key Point Summary
Added December 2018

Creation of an Adult Observation Unit: Improving Outcomes.

Author(s): Plamann, J. M., Zedreck-Gonzalez, J., Fennimore, L.
Many patients who visit emergency departments do not need to be admitted but also are not ready for discharge. To improve throughput and reduce wait time, an alternative would be placing them under observation in a special observation unit.
Key Point Summary
Added December 2017

Are Split Flow and Provider in Triage Models in the Emergency Department Effective in Reducing Discharge Length of Stay?

Author(s): Pierce, B. A., Gormley, D.
This paper presents a quality improvement (QI) project by comparing the performance of two different emergency departments (EDs). The idea behind the split flow model is to allow for a second flow stream of patients through the ED, parallel to the regular acute/critical care flow stream, that is ultimately intended for patients with problems that are not considered complex. The role of the provider in the triage (PIT) model is to enhance patient triage assessment by providing patients with an upfront evaluation upon entering the ED.
Key Point Summary
Added June 2016

What U.S. emergency care value transformation can learn from Canadian efforts to improve emergency department throughput

Author(s): Pines, J. M.
Added December 2015

Lean Manufacturing Improves Emergency Department Throughput and Patient Satisfaction:

Author(s): Kane, M., Chui, K., Rimicci, J., Callagy, P., Hereford, J., Shen, S., Norris, R., Pickham, D.
The Emergency Department (ED) in the authors’ organization was facing overcrowding, which was placing a strain on ED resources and resulting in a decrease in patient satisfaction. It was decided to extend to the ED the implementation of a lean management strategy, Stanford Operating System (SOS), already in use for hospital operations.
Key Point Summary
Added December 2015

Increasing Throughput: Results from a 42-Hospital Collaborative to Improve Emergency Department Flow

Author(s): Zocchi, M. S., McClelland, M. S., Pines, J. M.
The rates of visits to the emergency department (ED) in the U.S. have grown in the last 10 years. According to the authors, attempts to decrease crowding in the EDs have been largely through improving the flow, which has been challenged by several factors including inconsistency in the demand for ED services, ED staffing issues, and inconsistency in the availability of inpatient beds.
Key Point Summary
Added December 2015

Review article: Systematic review of three key strategies designed to improve patient flow through the emergency department

Author(s): Elder, E., Johnston, A. N., Crilly, J.
Added December 2015

The Impact of a Flexible Care Area on Throughput Measures in an Academic Emergency Department

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.
Key Point Summary
Added December 2015

Does an ED Flow Coordinator Improve Patient Throughput?

Author(s): Murphy, S. O., Barth, B. E., Carlton, E. F., Gleason, M., Cannon, C. M.
Added December 2015

Ready-JET-Go: Split Flow Accelerates ED Throughput

Author(s): Bish, P. A., McCormick, M. A., Otegbeye, M.
Emergency departments (ED) in America have seen large increases in demand for emergency services over the last decade. This increased demand for ED services has resulted in delayed treatment for patients, increased rates of patients leaving the ED without receiving treatment, and decreases in satisfactory ED visit experiences.
Key Point Summary
Added December 2015

Initiatives to reduce overcrowding and access block in Australian emergency departments: A literature review

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...
Key Point Summary
Added December 2015

Using Lean-Based Systems Engineering to Increase Capacity in the Emergency Department

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.
Key Point Summary
Added December 2015

Planning Intensive Care Unit Design Using Computer Simulation Modeling: Optimizing Integration of Clinical, Operational, and Architectural Requirements

Author(s): OʼHara, S.
Simulation modeling, according to the author, is a cost-effective way to test equipment utilization or the required number of beds, staffing models, and to examine ‘what-if scenarios’ for the design of Intensive Care Units (ICUs). The input of a nurse is valuable to both the design and simulation processes. This paper outlines the information a nurse needs to be equipped to be an effective participant in the planning team with architects and simulation engineers.
Key Point Summary
Added May 2015

Improving Front-End Flow in an Urban Academic Medical Center Emergency Department: The Emergency Department Discharge Facilitator Team

Author(s): Sharma, R., Mulcare, M. R., Graetz, R., Greenwald, P. W., Mustalish, A. C., Miluszusky, B., Flomenbaum, N. E.
Added May 2014