Changes in patient flow among five hospitals participating in a learning collaborative

Megan McHugh, Kevin J. Van Dyke, Embry Howell, Fiona Adams, Dina Moss, Julie Yonek

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


This was an evaluation of the efforts of five hospitals that participated in a collaborative aimed at improving patient flow and reducing emergency department (ED) crowding. Interviews with hospital implementation team members were conducted at two separate times, and multivariate linear regression models and bivariate logistic models were constructed to assess changes in ED length of stay (LOS) and left without being seen (LWBS). By the end of the collaborative, four of the five hospitals had at least one fully implemented improvement strategy. Those hospitals experienced modest improvements in patient flow: a hospital that implemented front-end improvements and devoted additional resources to fast track had a 51-min reduction in ED LOS, another that implemented only front-end improvements had a 9-min reduction in LOS, a third hospital that improved communication between the ED and inpatient units to facilitate admissions decreased LWBS from 0.6% to 0.4%, and a fourth hospital reduced LOS by 59 min for mid-acuity patients by establishing a new care process for them. Results suggest that relatively small changes may lead to improvements in measures of patient flow that are modest, at best.

Original languageEnglish (US)
Pages (from-to)21-29
Number of pages9
JournalJournal for healthcare quality : official publication of the National Association for Healthcare Quality
Issue number1
StatePublished - Jan 1 2013

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy


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