Volume-related differences in emergency department performance.
Jt Comm J Qual Patient Saf
; 38(9): 395-402, 2012 Sep.
Article
em En
| MEDLINE
| ID: mdl-23002491
ABSTRACT
BACKGROUND:
Emergency departments (EDs) are an important source of care for a large segment of the population of the United States. In 2009 there were more than 136 million visits to the ED each year, and more than half of hospital admissions begin in the ED. Measurement and monitoring of emergency department performance has been prompted by The Joint Commission's patient flow standards. A study was conducted to attempt to correlate ED volume and other operating characteristics with performance on metrics.METHODS:
A retrospective analysis of the Emergency Department Benchmarking Alliance annual ED survey data for the most recent year for which data were available (2009) was performed to explore observed patterns in ED performance relative to size and operating characteristics. The survey was based on 14.6 million ED visits in 358 hospitals across the United States, with an ED size representation (sampling) approximating that of the Emergency Medicine Network (EM Net).RESULTS:
Larger EDs (with higher annual volumes) had longer lengths of stay (p < .0001), higher left without being seen rates (p < .0001), and longer door-to-physician times (p < .0001), all suggesting poorer operational performance. Operating characteristics indicative of higher acuity were associated with worsened performance on metrics and lower acuity characteristics with improved performance.CONCLUSION:
ED volume, which also correlates with many operating characteristics, is the strongest predictor of operational performance on metrics and can be used to categorize EDs for comparative analysis. Operating characteristics indicative of acuity also influence performance. The findings suggest that ED performance measures should take ED volume, acuity, and other characteristics into account and that these features have important implications for ED design, operations, and policy decisions.
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Base de dados:
MEDLINE
Assunto principal:
Carga de Trabalho
/
Eficiência Organizacional
/
Serviço Hospitalar de Emergência
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Jt Comm J Qual Patient Saf
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Estados Unidos