Case Study to Improve Emergency Room Patient Flow at Womack Army Medical Center

摘要

This graduate project is a case study on how to improve patient flow in the emergency department (ED) at Womack Army Medical Center (WAMC). Results of the case study indicate that five definitions of patient flow allow for various improvement techniques to be applied in establishing recommendations to optimize flow and patient throughput in the WAMC ED. These key findings and recommendations include: 1. establishing patient flow within WAMC's strategic vision; 2. conducting hospital-wide patient flow analysis utilizing real-time, patient-centric data; 3. utilizing the ED length of stay (LOS) and ED left without being seen (LWOBS) rate as the key measures to improve ED patient flow; 4. analyzing the ED LOS and LWOBS rate by hour of day and day of the week for impacts on patient flow; 5. developing accurate forecasts on the daily average ED census to optimally align short-term and long-term staffing needs; 6. creating a set of ED queuing models that verify staff and space requirements for triage, registration, and treatment areas; 7. utilizing a set of ratios to identify specifically where WAMC ED capacity is not aligned with patient demand; 8. analyzing the impacts of both laboratory and radiology order cycle times on WAMC ED LOS improvement efforts; 9. evaluating the impacts of performing initial treatment in triage area to increase the service rate of main ED beds; and 10. analyzing the impacts of an ED patient tracking application on increasing the efficiency and metrics effectiveness of WAMC ED staff to care for patients.