The role of operations management in improving emergency department outflow

摘要

Worldwide, many hospitals experience problems in patient outflow from the emergency department into the clinical wards, and therefore, implement an observation unit. Literature and practical experiences, however, show that medical management in these units can be problematic. A university hospital in the Netherlands that considered implementation first analysed the problem situation using an operations management approach. For the internal medicine specialty, the steps in the patients' care delivery and the deployment of staff and resources around acute admissions were analysed. The analyses brought up many inefficiencies in the admission process and showed that nurse staffing levels in the wards did not match patient outflow from the emergency department. The results provided hospital management with more and less extensive options to address the problem situation. These were implemented first, instead of an observation unit. We encourage healthcare managers who face similar decisions to incorporate operations management aspects into their decision-making processes.