TY - JOUR
T1 - Changes in patient flow among five hospitals participating in a learning collaborative
AU - McHugh, Megan
AU - Van Dyke, Kevin J.
AU - Howell, Embry
AU - Adams, Fiona
AU - Moss, Dina
AU - Yonek, Julie
PY - 2013/1/1
Y1 - 2013/1/1
N2 - 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.
AB - 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.
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U2 - 10.1111/j.1945-1474.2011.00163.x
DO - 10.1111/j.1945-1474.2011.00163.x
M3 - Article
C2 - 22092988
AN - SCOPUS:84891396753
VL - 35
SP - 21
EP - 29
JO - Journal of quality assurance : a publication of the National Association of Quality Assurance Professionals
JF - Journal of quality assurance : a publication of the National Association of Quality Assurance Professionals
SN - 1062-2551
IS - 1
ER -