A Focus on Improving Patient Flow
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With ED crowding continuing to be an important public health issue, hospitals across the United States are scrambling to pursue aggressive strategies that improve patient flow in EDs. A logistics management program (LMP) has been initiated in some EDs. The program expands the bed management process to include a systematic approach to patient flow throughout the facility. With LMPs, a clinical liaison or field agent drives throughput at all points of care.
For a recent study, investigators sought to examine the effects of an LMP on ED length of stay (LOS) and inpatient LOS. The quasi-experimental study involved 28,684 ED admissions in a suburban, tertiary medical center and analyzed data before and after implementing an LMP. According to findings, the median ED evaluation time was 219 minutes prior to implementing an LMP but decreased to 207 minutes after implementation. The median ED placement time decreased from 219 minutes before implementation to 193 minutes after it was implemented. After implementing the LMP, the median inpatient LOS decreased from 3.93 days to 3.83 days, representing a reduction of 1,483 inpatient days.
The research team indicated that their results provide strong evidence to support the impact of an LMP on decreasing ED evaluation times, ED placement times, and inpatient LOS. They added, however, that more studies are needed to examine the program as a potential best practice and to assess its applicability for other facilities.
