Towards a New Approach for Developing Patient Flow in Emergency Department: Sahloul and Hached Hospitals Case Study

PurposeA process that does not include the customer's value may not be effective in providing care. This study aimed to identify value and waste in an emergency department (ED) patient flow process from a patient and clinician perspective.Design/methodology/approachA qualitative case study was conducted in an ED in Trinidad and Tobago. Observations and informal conversational interviews with clinicians (n = 33) and patients (n = 50) explored patient flow, value and waste. Thematic analysis was used to create a framework on valuable and wasteful aspects in the ED patient flow process.FindingsValuable aspects led to direct improvements in the patient's health or an exchange of information in the process. Wasteful aspects were those with no patient activity, no direct ED clinical involvement, or resulted in a perceived inappropriate use of ED resources. However, there was a disparity in responses between clinicians and patients with clinicians identifying more features in the process.Research limitations/implicationsThe single case study design limits the generalizability of findings to other settings. This study did not specifically explore the influence of age and gender on what mattered to patients in ED services. Future studies would benefit from exploring whether there are any age and gender differences in patient perspectives of value and waste. Further research is needed to validate the usefulness of the framework in a wider range of settings and consider demographic factors such as age and gender.Practical implicationsThe study has produced a framework which may be used to improve patient flow in a way that maximized value to its users. A collaborative approach, with active patient involvement, is needed to develop a process that is valuable to all. The single case study design limits the generalizability of findings to other settings.Originality/valueQualitative methods were used to explicitly explore both value and waste in emergency department patient flow, incorporating the patient perspective. This paper provides an approach that decision makers may use to refine the ED patient flow process into one that flows well, improves quality and maximizes value to its users.

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Revitalizing Ways of Korean Traditional Markets through A Overseas Case Study: A New Approach to Revitalize Korean Traditional Markets

Korea Association of Business Education ◽

10.23839/kabe.2018.33.3.153 ◽

2018 ◽

Vol 33 (3) ◽

pp. 153-173

Author(s):

Heung－Seob Chang

Keyword(s):

New Approach ◽

Traditional Markets

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The Impact of a Concierge Medicine Model on Door to Doctor Time and Patient Flow in an Urban Emergency Department

Open Access Emergency Medicine ◽

10.2147/oaem.s228291 ◽

2020 ◽

Vol Volume 12 ◽

pp. 13-18

Author(s):

Asher L Mandel ◽

Thomas Bove ◽

Amisha D Parekh ◽

Paris Datillo ◽

Joseph Bove Jr ◽

...

Keyword(s):

Emergency Department ◽

Patient Flow ◽

The Impact ◽

Urban Emergency Department

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Benefit Corporations Approach to Environmental, Social and Governance Disclosure: A Focus on Italy

Entrepreneurship Research Journal ◽

10.1515/erj-2019-0318 ◽

2020 ◽

Vol 10 (4) ◽

Author(s):

Mauro Sciarelli ◽

Silvia Cosimato ◽

Giovanni Landi

Keyword(s):

Qualitative Method ◽

Positive Impact ◽

Corporate Structure ◽

New Approach ◽

For Profit ◽

Benefit Corporation ◽

Benefit Corporations ◽

Multiple Case ◽

Governance Disclosure

AbstractOver the last decades, Benefit Corporations arouse as a new corporate structure, alternative to traditional ones and pointing to offer a new approach to the management of business and sustainability issues. These companies' activities are statutory aimed at bridging for-profit and no-profit activities; thus, they intentionally and statutory pursue economic purposes together with social and environmental ones, to create a positive impact on economy, society and environment. Even though, Italian and other national laws set some specific disclosure duties for Benefit Corporations, especially in terms of Environmental, Social and Governance (ESG) issues, the literature still calls for further research on the topic. Therefore, this paper is aimed at contributing to bridge this gap, investigating the way Italian Benefit Corporations approach ESG disclosure. To this end, an exploratory analysis has been conducted, implementing a qualitative method, based on a multiple case study strategy. Even though the descriptive nature of the study, the achieved findings pointed out that the Benefit Corporation structure not necessarily implies a better approach to ESG.

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Incorporating lines of evidence from New Approach Methodologies (NAMs) to reduce uncertainties in a category based read-across: A case study for repeated dose toxicity

Regulatory Toxicology and Pharmacology ◽

10.1016/j.yrtph.2020.104855 ◽

2021 ◽

Vol 120 ◽

pp. 104855

Author(s):

Cynthia B. Pestana ◽

James W. Firman ◽

Mark T.D. Cronin

Keyword(s):

Repeated Dose ◽

New Approach ◽

Repeated Dose Toxicity ◽

Lines Of Evidence

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Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency Department Workflow

Canadian Association of Radiologists Journal ◽

10.1177/08465371211023861 ◽

2021 ◽

pp. 084653712110238

Author(s):

Francesco Macri ◽

Bonnie T. Niu ◽

Shannon Erdelyi ◽

John R. Mayo ◽

Faisal Khosa ◽

...

Keyword(s):

Emergency Department ◽

Major Trauma ◽

Patient Flow ◽

Interrupted Time Series ◽

Trauma Patients ◽

Linear Regression Models ◽

High Acuity ◽

Time Series Approach ◽

Comparison Series ◽

The Impact

Purpose: Assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on Emergency Department (ED) patient flow in an urban, quaternary-care teaching hospital. Methods: Patient ED visit and imaging information were extracted from the hospital patient care information system for 2008 to 2018. An interrupted time-series approach with a comparison group was used to study the impact of 24/7/365 ETR on average monthly ED length of stay (ED-LOS) and Emergency Physician to disposition time (EP-DISP). Linear regression models were fit with abrupt and permanent interrupts for 24/7/365 ETR, a coefficient for comparison series and a SARIMA error term; subgroup analyses were performed by patient arrival time, imaging type and chief complaint. Results: During the study period, there were 949,029 ED visits and 739,796 diagnostic tests. Following implementation of 24/7/365 coverage, we found a significant decrease in EP-DISP time for patients requiring only radiographs (-29 min;95%CI:-52,-6) and a significant increase in EP-DISP time for major trauma patients (46 min;95%CI:13,79). No significant change in patient throughput was observed during evening hours for any patient subgroup. For overnight patients, there was a reduction in EP-DISP for patients with symptoms consistent with stroke (-78 min;95%CI:-131,-24) and for high acuity patients who required imaging (-33 min;95%CI:-57,-10). Changes in ED-LOS followed a similar pattern. Conclusions: At our institution, 24/7/365 in-house ETR staff radiology coverage was associated with improved ED flow for patients requiring only radiographs and for overnight stroke and high acuity patients. Major trauma patients spent more time in the ED, perhaps reflecting the required multidisciplinary management.

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