In this CHOT study, a new flow model of emergency care delivery, physician-directed queuing (PDQ), was created after analysis of operational data and staff input of an overcrowded academic health center emergency department (ED) with increasing patient volumes and limited physical space for expansion. After implementing the PDQ model, the researchers observed a 91% decrease in door-to-bed time (211 to 19 minutes), an 83% decrease average waiting time (70 to 12 minutes), and increased patient satisfaction (from 17% to 85%). In order to design this PDQ, researchers analyzed the operational data and staff input of an overcrowded academic health center emergency department (ED) with increasing patient volumes and limited physical space for expansion. EDs are a critical point of entry into the healthcare system. ED overcrowding create barriers to access and provision of appropriate care. ED crowding is associated with less timely care, decreases in patient satisfaction, and poor outcomes. With the new PDQ model, providers passively evaluate all patients upon arrival, actively manage patients requiring fewer resources, and direct patients requiring complex resources to further evaluation in ED areas. This model of practice can be applied to other patient care settings such as ambulatory care and imaging.
DeFlitch, C., Geeting, G., & Paz, H. L. (2015). Reinventing emergency department flow via healthcare delivery science. HERD : Health Environments Research & Design Journal, 8(3), 105-115.
Harriet Nembhard, PhD