The impact of the healthcare environment on patient experience in the emergency department: A systematic review to understand the implications for patient-centered design
2023
HERD: Health Environments Research & Design Journal
Journal Article
Issue 2
Volume 16
Pages 310-329
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
Added December 2022
Leveraging discrete event simulation modeling to evaluate design and process improvements of an emergency department
2022
Journal of Design for Resilience in Architecture and Planning
Journal Article
Issue 3
Volume 3
Pages 397-408
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.
Added December 2022
Analysis of functional layout in emergency departments (ED). Shedding light on the free standing emergency department (FSED) model
2022
Applied Sciences
Journal Article
Issue 10
Volume 12
Pages 5099
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.
Added December 2022
Creation of an Adult Observation Unit: Improving Outcomes.
2018
Journal of Nursing Care Quality
Journal Article
Issue 1
Volume 33
Pages 72-78
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.
Added December 2017
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
Are Split Flow and Provider in Triage Models in the Emergency Department Effective in Reducing Discharge Length of Stay?
2016
Journal of Emergency Nursing
Journal Article
Issue 6
Volume 42
Pages 487-491
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.
Added June 2016
Increasing Throughput: Results from a 42-Hospital Collaborative to Improve Emergency Department Flow
2015
The Joint Commission Journal on Quality and Patient Safety
Journal Article
Issue 12
Volume 41
Pages 532–553
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.
Added December 2015
Ready-JET-Go: Split Flow Accelerates ED Throughput
2015
Journal of Emergency Nursing
Journal Article
Issue 2
Volume 42
Pages 114-119
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.
Added December 2015
Lean Manufacturing Improves Emergency Department Throughput and Patient Satisfaction:
2015
Journal of Nursing Administration
Journal Article
Issue 9
Volume 45
Pages 429-434
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.
Added December 2015
Review article: Systematic review of three key strategies designed to improve patient flow through the emergency department
2015
Emergency medicine Australasia: EMA
Journal Article
Issue 5
Volume 27
Pages 394-404
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
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
Does an ED Flow Coordinator Improve Patient Throughput?
2014
Journal of Emergency Nursing
Journal Article
Issue 6
Volume 40
Pages 605-612
Author(s): Murphy, S. O., Barth, B. E., Carlton, E. F., Gleason, M., Cannon, C. M.
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
Improving Front-End Flow in an Urban Academic Medical Center Emergency Department: The Emergency Department Discharge Facilitator Team
2013
Journal of Urban Health
Journal Article
Issue 3
Volume 90
Pages 406-411
Author(s): Sharma, R., Mulcare, M. R., Graetz, R., Greenwald, P. W., Mustalish, A. C., Miluszusky, B., Flomenbaum, N. E.
Added May 2014
