Factors contributing to delay in throughput within the emergency department which influence emergency department overcrowding.

摘要

Delays in Emergency department throughput for critically ill patients are obstacles which contribute to ED overcrowding. Overcrowding in the ED can lead to compromised critical patient safety and delays in recognizing deterioration in a patient's condition and starting critical interventions. A general systems theory describing ED process as input, throughput and output was the framework used in this study. A quantitative, retrospective, electronic chart review of critically ill patients was performed to analyze interval times for patient processes performed within the ED. All adult patients admitted to critical care units from the ED during the third and fourth quarters of 2009 have been included. A sample of 50 charts were reviewed of critically ill patients admitted directly from the ED from July 1, 2009 to December 31, 2009. The knowledge gained from these findings, which were the identification of increased time spent in the ED due to an admission MD assessment plus the arrival of patients during the first shift, was found to impact ED throughput and ED overcrowding. Through the identification of these multiple factors which were found within the ED, policies on improving these delays can improve throughput process of all patients seen in the ED.