Many U.S. hospitals have not yet adopted several well regarded practices to reduce long wait times and minimize delays in their emergency departments, according to a new study published in Health Affairs.
The study's authors used data from the National Hospital Ambulatory Medical Care Survey, an annual survey that includes approximately 36,000 hospital-based ED visits, to evaluate the use of interventions to address crowding in U.S. hospitals in the period of 2007 to 2010. They specifically looked at the relationship between crowding within an ED itself, based on patients' length of stay and the number of interventions adopted. Hospitals were divided into quartiles from least to most crowded.
Here are five findings from the study.
1. From 2007 to 2010, the average number of interventions adopted increased from 5.2 to 6.6, and seven of the 17 studied interventions saw a significant increase in adoption. Interventions included separating patients with minor problems from those with more serious problems to improve workflow, computer-assisted triage systems and hospital protocols to move admitted patients out of the ED to inpatient areas to await room assignment, rather than "boarding" them in the emergency department, according to Kaiser Health News.
2. In general, more crowded EDs adopted greater numbers of interventions than less crowded EDs.
3. However, in the most crowded quartile of EDs, a large proportion had not adopted effective interventions: 19 percent did not use bedside registration, and 94 percent did not use surgical schedule smoothing. "Thus, while adoption of strategies to reduce ED crowding is increasing, many of the nation's most crowded EDs have not adopted proven interventions," the study's authors wrote.
4. In 2010, 50 percent of patients in the least crowded quartile of EDs spent less than 93 minutes there, while 50 percent of patients in the most crowded quartile of EDs had a length of stay of more than 160 minutes, according to Kaiser Health News.
5. In 2010, nearly 40 percent of the emergency departments in the most crowded quartile adopted "full-capacity protocols" where admitted patients are boarded in inpatient areas instead of the ED, according to Kaiser Health News. Overall, those practices were occuring in 46 percent of all hospitals in 2010.
More articles on capacity management:
Chambersburg Hospital to open NICU: 4 things to know
4 Cleveland systems make pact to stop periodic ER closures: 5 things to know
Lahey helps open the Middle East's 1st privately run women's health center: 6 things to know