42-hospital collaboration yields significant improvements in measures of ED flow

An 18-month collaboration among hospitals across 16 communities has resulted in the implementation of 172 emergency department interventions and a number of ED flow improvements, according to an article in The Joint Commission Journal on Quality and Patient Safety.

Two-thirds of the 42 participating hospitals demonstrated improvements on at least one of four measures of ED flow: discharged length of stay, admitted length of stay, boarding time and left without being seen. Among hospitals that reported improvements, the average reduction in discharged LOS was 26 minutes, admitted LOS decreased by 36.5 minutes, boarding time fell by 20.9 minutes and LWBS rates decreased by 1.4 absolute percentage points.

Factors such as engaged leadership, sufficient resources and staff buy-in are fundamental elements of successful ED flow improvements, the authors wrote. Although most hospitals did report improved ED flow on at least one of the four measures, 14 of the hospitals did not. The authors note C-suite support was a requirement for initial enrollment in the collaborative, but there was no requirement for active leadership participation on the improvement teams, which may have stalled improvement for participating hospitals.

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