scholarly journals Emergency Department Overcrowding in Turkey: Reasons, Facts and Solutions

2014 ◽  
Vol 52 (195) ◽  
pp. 878-885 ◽  
Author(s):  
Oya Durmus Cakir ◽  
Sebnem Eren Cevik ◽  
Mehtap Bulut ◽  
Ozlem Guneyses ◽  
Sule Akkose Aydin
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Average Length ◽  
Waiting Times ◽  
Pediatric Trauma ◽  
University Hospital ◽  
Trauma Patients ◽  
Factors Affecting ◽  
Average Length Of Stay ◽  
Bed Capacity

Introduction: The purpose of this study was to determine the factors affecting the long waiting times of the patients in a university hospital. Methods: This study included 3000 of the adults above 18 years and pediatric trauma patients under 18 years who applied to emergency department between February 2009 and April 2009. The examination period of the physician, length of stay, length of hospitalization, waiting times for hospitalization and follow up times in the emergency department were recorded. Moreover, the patients were divided into four groups according to the reasons for waiting. Results: In our study, the time period between 4 pm-12 pm was determined as the busiest time for the applications. Average length of stay in the emergency department for 3000 patients was 146.7±160.2 minutes. The length of stay for the patients consulted was longer than the length of stay for the ones who were not consulted. Because of the fact that our hospital did not have appropriate bed capacity, 41.1% of the patients waited less than two hours, 13. 4% of the patients waited more than 8 hours. It was also found that the waiting times of the Group two patients (206,7±145,2 minutes) was longer than Group one (95,5±73,9 minutes) patients and the waiting times of Group three patients (470,7±364,7 minutes) was longer than Group one patients. Conclusions: In conclusion, cooperation of the managers, relevant departments and a multidisciplinary approach are necessary to achieve the goals to reduce overcrowding in the emergency departments.  Keywords: bed capacity; crowding; emergency department; length of stay.  

scholarly journals Emergency Surgery in A Tertiary Hospital: The Covid-19 Experience

2020 ◽  
Author(s):  
Gennaro Perrone ◽  
Mario Giuffrida ◽  
Elena Bonati ◽  
Paolo Del Rio ◽  
Vittoria Pattonieri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Acute Appendicitis ◽  
Acute Cholecystitis ◽  
Emergency Surgery ◽  
Average Length ◽  
Medical Science ◽  
University Hospital ◽  
Average Length Of Stay ◽  
The Impact

Objective: Evaluate the impact of Covid-19 in a critical area and analyze the changes in the daily activities in an Emergency Department of a tertiary COVID-Hospital. Methods: We reported and compared the surgical procedures performed for acute appendicitis and acute cholecystitis between two periods (March and April 2019 and March and April 2020) at Emergency Surgery Department of Parma University Hospital, a tertiary COVID-Hospital. Results: A total of 72 patients underwent surgery between March and April 2019 and 36 between March and April 2020 for acute appendicitis and cholecystitis. The average length of stay was comparable in the two considered years for LA (4.23±1.69 days in 2019 versus 4.5±2.33 days in 2020). The average length of stay in patients with acute cholecystitis was 5.9±3.8 days in 2019 and 8.23±5.5 days in 2020(P=0.038). The average hospitalization was comparable with 2019 data (5.62±3.77 days)n March 2020;whereas, April 2020 was statistically significantly longer 10.5±6 days (P= 0.023). Conclusions: Half of the emergency centers reported a drop in the overall number of urgent cases as confirmed in our department, where the number of total appendicectomy and cholecystectomy was halved comparing the two months in 2019 and 2020, 72 operations in 2019 versus 36 operations in 2020.During the pandemic, the confidence of the population to the healthcare systems was poor, and this can explain the delayed access to the emergency department of patients who suffered from an acute illness. Bangladesh Journal of Medical Science Vol.19(0) 2020 p. S 66-S 68

scholarly journals Impact of streaming "fast track" emergency department patients

2006 ◽  
Vol 30 (4) ◽  
pp. 525 ◽  
Author(s):  
Debra O'Brien ◽  
Aled Williams ◽  
Kerrianne Blondell ◽  
George A Jelinek
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Waiting Time ◽  
Fast Track ◽  
Average Length ◽  
Waiting Times ◽  
Relative Reduction ◽  
Average Waiting Time ◽  
Discharged Patients ◽  
Track Area

Objective: Fast track systems to stream emergency department (ED) patients with low acuity conditions have been introduced widely, resulting in reduced waiting times and lengths of stay for these patients. We aimed to prospectively assess the impact on patient flows of a fast track system implemented in the emergency department of an Australian tertiary adult teaching hospital which deals with relatively few low acuity patients. Methods: During the 12-week trial period, patients in Australasian Triage Scale (ATS) categories 3, 4 and 5 who were likely to be discharged were identified at triage and assessed and treated in a separate fast track area by ED medical and nursing staff rostered to work exclusively in the area. Results: The fast track area managed 21.6% of all patients presenting during its hours of operation. There was a 20.3% (?18 min; 95%CI, ?26 min to ?10 min) relative reduction in the average waiting time and an 18.0% (?41 min; 95%CI, ?52 min to ?30 min) relative reduction in the average length of stay for all discharged patients compared with the same period the previous year. Compared with the 12-week period before the fast track trial, there was a 3.4% (?2.1 min; 95%CI, ?8 min to 4 min) relative reduction in the average waiting time and a 9.7% (?20 min; 95%CI, ?31 min to ?9 min) relative reduction in the average length of stay for all discharged patients. There was no increase in the average waiting time for admitted patients. This was despite major increases in throughput and access block in the study period. Conclusion: Streaming fast track patients in the emergency department of an Australian tertiary adult teaching hospital can reduce waiting times and length of stay for discharged patients without increasing waiting times for admitted patients, even in an ED with few low acuity patients.

Improving service in an emergency department by designing the health production flow

2019 ◽  
Vol 33 (2) ◽  
pp. 76-85
Author(s):  
Oscar Barros ◽  
Rodrigo Riffo ◽  
Inti Paredes
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Average Length ◽  
Conservative Estimate ◽  
Health Production ◽  
Production Flow ◽  
Large Hospital ◽  
Direct Evaluation ◽  
Average Length Of Stay ◽  
Formal Design

Background Most emergency departments have overcapacity with poor service measured by length of stay. We hypothesized that a formal design of the emergency department production flows will improve service. Thus, we propose a methodology that was tested in a large hospital, including new flow implementation. Results We implemented new workflows during June to July 2017. A comparison of the patients’ average length of stay from June to September shows a decrease of 26%. Additionally, a comparison with 2016 shows a decrease of 50%. Direct evaluation of the value generated reveals an emergency department admissions increase of 540 monthly, equivalent of a savings of approximately US$250.000 annually. This savings is a very conservative estimate because the most significant value of this work is fast service that diminishes the patients’ risks. Conclusions Production design is an important problem in health services in terms of potential service improvements, executable with a formal, systemic, replicable method founded on several disciplines. Thus, we are replicating the approach at other hospitals with extensions to other services.

Improving Emergency Department Time to Provider, Left-Without-Treatment Rates, and Average Length of Stay

2013 ◽  
Vol 45 (3) ◽  
pp. 426-432 ◽  
Author(s):  
Ghazala Q. Sharieff ◽  
Lori Burnell ◽  
Matt Cantonis ◽  
Valerie Norton ◽  
Juan Tovar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Average Length ◽  
Average Length Of Stay

scholarly journals Designing Hospital Key Performance Indicators for Academic Centers: Measuring the Average Length of Stay

2016 ◽  
Vol 6 (1) ◽  
pp. 5-11
Author(s):  
Omar A. Ayoub ◽  
Mohamed N. AlAma ◽  
Kamal M. AlGhalayini ◽  
Wesam A. Alhejily ◽  
Mohammed S. Abdulwahab ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Performance Indicator ◽  
Average Length ◽  
Performance Measure ◽  
University Hospital ◽  
Patient Specific ◽  
Design Quality ◽  
Average Length Of Stay ◽  
Risk Patients

Background: Length of stay is an important performance indicator for hospital management and a key measure of health care efficiency. This paper aims to determine the average length of stay in our center and the factors that influence it. We also investigate whether our hospital's length of stay is a key performance measure that can be used to design quality improvement initiatives. Methods: We performed a retrospective analysis of hospitalizations at the Multi-disciplinary Internal Medicine Department of King Abdulaziz University Hospital, Jeddah between 2010 and 2013. We collected data including demographics, admitting diagnosis, admitting unit, treatments administered, and history of transfer from the Intensive Care Unit. Results: The mean length of stay was 5.9 (6.8) days. Patients admitted through the Emergency Department were more likely to have a longer hospital stay compared with those admitted through Day Care or the Outpatient Department (P < 0.001). Expatriates (P < 0.001), bedridden patients (P = 0.02), and those who received prophylaxis for deep venous thrombosis (P < 0.001) were more likely to have a longer length of stay than the rest of the sample. Furthermore, patients admitted in the morning hours had a significantly shorter length of stay than those admitted in the evening hours (P < 0.001). Conclusion: The length of stay among patients at our department is affected by hospital- or patient-specific factors. Health care can be improved by identifying and monitoring the length of stay in high-risk patients.  

scholarly journals National University Hospital discharge survey in the Islamic Republic of Iran

2000 ◽  
Vol 6 (2-3) ◽  
pp. 402-408
Author(s):  
S. M. Reza Khatami ◽  
S. K. Kamrava ◽  
B. Ghatehbaghi ◽  
M. Mirzazadeh
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Hospital Discharge ◽  
Average Length ◽  
Health Care Service ◽  
Health Care Facilities ◽  
University Hospital ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay

We aimed to determine the rate of hospital discharge, average length of stay and bed occupancy rate in different hospital wards around the country. The survey consisted of health care service activities from 452 university-related hospitals in the country with a total of 59 348 beds. Because of missing data, the use of 56 315 of these beds was analysed. The countrywide discharge rate was 68.32 patients/1000 population per year with an average length of stay of 3.60 days and a bed occupancy rate of 57.44%. The data could be used to design a framework for prediction of inpatient health care facilities needed in the future

scholarly journals The impact of inpatient bed capacity on length of stay

2021 ◽  
Author(s):  
Brendan Walsh ◽  
Samantha Smith ◽  
Maev-Ann Wren ◽  
James Eighan ◽  
Seán Lyons
Keyword(s):  
Length Of Stay ◽  
Fixed Effects ◽  
Public Hospital ◽  
Negative Binomial ◽  
Average Length ◽  
Average Length Of Stay ◽  
Bed Capacity ◽  
Direction Of Causation ◽  
The Impact ◽  
Inpatient Length Of Stay

Abstract Objective Large reductions in inpatient length of stay and inpatient bed supply have occurred across health systems in recent years. However, the direction of causation between length of stay and bed supply is often overlooked. This study examines the impact of changes to inpatient bed supply, as a result of recession-induced healthcare expenditure changes, on emergency inpatient length of stay in Ireland between 2010 and 2015. Study design We analyse all public hospital emergency inpatient discharges in Ireland from 2010 to 2015 using the administrative Hospital In-Patient Enquiry dataset. We use changes to inpatient bed supply across hospitals over time to examine the impact of bed supply on length of stay. Linear, negative binomial, and hospital–month-level fixed effects models are estimated. Results U-shaped trends are observed for both average length of stay and inpatient bed supply between 2010 and 2015. A consistently large positive relationship is found between bed supply and length of stay across all regression analyses. Between 2010 and 2012 while length of stay fell by 6.4%, our analyses estimate that approximately 42% (2.7% points) of this reduction was associated with declines in bed supply. Conclusion Changes in emergency inpatient length of stay in Ireland between 2010 and 2015 were closely related to changes in bed supply during those years. The use of length of stay as an efficiency measure should be understood in the contextual basis of other health system changes. Lower length of stay may be indicative of the lack of resources or available bed supply as opposed to reduced demand for care or the shifting of care to other settings.

scholarly journals 28 Can Comprehensive Geriatric Assessment be Achieved in the Emergency Department?

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
J Cheng ◽  
C Ho ◽  
K Honney ◽  
M Wells ◽  
W Wise ◽  
...  
Keyword(s):  
Emergency Department ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Average Length ◽  
University Hospital ◽  
Emergency Setting ◽  
Care Plans ◽  
Average Length Of Stay ◽  
Standard Tool ◽  
The Uk

Abstract Background Our National Health Service is facing unprecedented challenges to accommodate our frailer healthcare users. The gold standard tool for the identification and management of frailty is the Comprehensive Geriatric Assessment (CGA) and has been shown to lead to better outcomes in terms of morbidity and mortality. Introduction With a largely elderly demographic profile in the East of England, the Norfolk and Norwich University Hospital opened the first Older People’s Emergency Department (OPED) in the UK in 2017. This work reviews the effectiveness of a geriatrician-led CGA in a dedicated OPED, which operates during daylight hours, compared to usual care in Accident & Emergency (A&E). Methods 99 patients assessed in OPED and 99 patients assessed overnight in A&E during February 2019 were included in this retrospective study. Electronic case notes for each patient were reviewed by the authors and results were expressed as percentages. Results OPED outperformed A&E in all components of the CGA; strongest areas included assessing for pain, falls risk and activities of daily living. Both departments performed well in reviewing medications and assessing for safeguarding concerns. Areas for improvement include assessing for mood disorders, sensory impairment, discussing Do Not Attempt Cardiopulmonary Resuscitation status, and end of life care plans. The average length of stay of OPED patients was only 7.3 days compared to 8.7 days in A&E, and 89% of OPED patients were discharged back to their usual residences compared to 87% in A&E. Conclusions The improved CGA process in OPED has led to better outcomes, notably through a reduction in the average length of inpatient stay. Nevertheless, certain components of the CGA still require improvement. Further examination is needed to assess long-term mortality to support the use of CGA in the emergency setting.

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