Abstract
Background
Emergency Department (ED) service evaluations are typically based on surveys of discharged
patients. Physicians/administrators benefit from data that quantifies system-based
factors that adversely impact the experience of those who represent the survey cohort.
Objective
While investigators have established that admitted patient boarding impacts overall
ED throughput times, we sought to specifically quantify the relationship between throughput
times for patients admitted (EDLOS) versus discharged home from the ED (DCLOS).
Methods
We performed a prospective analysis of consecutive patient encounters at an inner-city
ED. Variables collected: median daily DCLOS for ED patients, ED daily census, left
without being seen (LWBS), median door to doctor, median room to doctor, and daily
number admitted. Admitted patients divided into 2 groups based on daily median EDLOS
for admits (<6 hours, ≥6 hours). Continuous variables analyzed by t-tests. Multivariate regression utilized
to identify independent effects of the co-variants on median daily DCLOS.
Results
We analyzed 24,127 patient visits. ED patient DCLOS was longer for patients seen on
days with prolonged EDLOS (193.7 minutes, 95%CI 186.7–200.7 vs. 152.8, 144.9–160.5,
P< .0001). Variables that were associated with increased daily median EDLOS for admits
included: daily admits (P= 0.01), room to doctor time (P< .01), number of patients that left without being seen (P< .01). When controlling for the covariate daily census, differences in DCLOS remained
significant for the ≥6 hours group (189.4 minutes, 95%CI 184.1–194.7 vs. 164.8, 155.7–173.9 (P< .0001).
Conclusion
Prolonged ED stays for admitted patients were associated with prolonged throughput
times for patients discharged home from the ED.
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Article Info
Publication History
Published online: June 05, 2016
Accepted:
June 1,
2016
Received in revised form:
May 9,
2016
Received:
January 17,
2016
Footnotes
☆Financial Disclosures/Conflicts: None.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
