A study published in the Academic Emergency Medicine journal found that a one-hour increase in emergency department (ED) length of stay (LOS) increases the odds of an increase in left without being seen rates by 44 percent. That same study also found that increased ED LOS is associated with decreased patient satisfaction and increased time for pain management.
Length of stay in the emergency department can be divided into three definitions: arrival time to admission, discharge, or transfer time. Unfortunately, the majority of hospitals don’t achieve recommended wait times for ED patients, leading to overcrowding, medical errors, and even mortality.
More complex patients tend to have longer lengths of stay. A Massachusetts study found that mental health patients in the state spend longer in the ED than patients without comorbid mental health conditions. The study also found that uninsured patients or patients with Medicaid were twice as likely to experience an ED LOS of 24 hours or longer, compared to privately-insured patients.
How to Reduce ED Length of Stay
Create a “Fast Track” for Patients With Less-Urgent Needs
Research shows that separating patients by high- or low-acuity conditions and creating a “fast track” process for those with low-acuity conditions helps reduce length of stay. This is achieved by:
- Establishing a standardized workflow
- Setting team expectations
- Generating and sharing data reports
- Creating a separate area of the ED for the fast track team
- Enlisting hospital leadership
Streamline the Triage Process
A case study published in NEJM Catalyst shows that streamlining triage processes by adapting workflows to meet patient demand can help reduce ED congestion.
At the ED at Ann & Robert H. Lurie Children’s Hospital of Chicago, patients often experienced either full exam rooms or full triage areas. Staff were able to remove these bottlenecks by moving some steps of triage to empty rooms. Likewise, steps typically done in exam rooms could be moved to triage when rooms were occupied.
Take Advantage of What Technology Has to Offer
One study found that health information exchange (HIE) adoption was associated with a reduction in LOS by over 10 percent. Taking advantage of the information that HIEs and solutions like Collective Medical’s care collaboration platform provides can help clinicians avoid duplicate tests and treatments, reduce unnecessary admissions, and make better care decisions for the benefit of patients.
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