ED rapid assessment zone improves patient throughput, reduces bottlenecks

Using a rapid assessment zone model in a high-volume emergency department can help reduce front-end bottlenecks, according to a study published in the Annals of Emergency Medicine.

Researchers conducted a retrospective study of consecutive patient visits at an urban community ED. They compared six-month periods before and after implementation of a rapid assessment zone.

The rapid assessment zone model involves splitting patient flow according to age and chief complaint on arrival, allowing clinicians to get patients into beds more quickly. A designated rapid assessment zone is created to expedite treatment of patients who are likely to remain ambulatory. The zone also serves as flexible acute care space.

Researchers analyzed 43,847 visits in the six months before the implementation of the model and 44,792 visits in the six months after.

The implementation of the model was linked to the following changes:

• Median ED length of stay decreased from 203 to 171 minutes
• Median arrival-to-provider time reduced from 28 to 13 minutes
• Leaving before treatment completion dropped from 1 percent to 0.8 percent
• Leaving before being seen decreased from 3.1 percent to 0.5 percent

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