A collaborative effort by 42 hospitals in 16 U.S. communities to improve patient flow in their emergency departments led to measurable improvements at two-thirds of the hospitals, according to a study published in the December issue of The Joint Commission Journal on Quality and Safety.
During the 18-month effort, organized by the Aligning Forces for Quality program, hospitals reduced their discharged length of stay by 26 minutes, their admitted length of stay by 36.5 minutes and their boarding time by nearly 21 minutes, according to the study abstract.
The rate of patients who left without being seen also fell by 1.4 percent percentage points, according to the abstract. Together, the hospitals took 172 actions, or interventions, during the October 2010 to March 2012 study period.
During that time period nearly half of hospital leaders said their EDs were overcrowded, and 43 percent ranked ED patient flow as their main challenge.
Although most of the hospitals in the collaborative improved on at least one measure of ED throughput, 14 hospitals did not demonstrate improvement.The researchers said those hospitals that didn't succeed may not have had C-suite leaders actively involved in the improvement teams, which may have stalled or even stopped some projects. They concluded that successful approaches to ED flow improvement require engaged leaders, staff buy-in and sufficient resources
The problems are far from solved. Long ED wait times continue to be an issue across the country, prompting continuing efforts to improve processes and strategies.