As they say, Slower you go the sicker you become? ED swarming have been a substantial problem for United States for a long time now. Hospitals are facing an increase in demand for emergency services but resources available are fewer. This leads to poor patient flow and lengthened stay in the ED of the hospital. ED crowding is a major health issue, directly affecting the apprehensions of patients.This research is geared toward the administration and staff of emergency department and how the overcrowding of the emergency department creates problems for staff and patients and how it decrease overall efficiency of hospital staff. In this study we will investigate emergency department throughput times in correlation with reported length of stay (LOS) and mortality rates to discover the relationship between throughput times and mortality rates While you where waiting in the emergency department did you die a little? Well obviously we hope not but increased emergency through put times could be linked to increased mortality rates and increased length of stay (LOS).
This particular study is geared toward the emergency department administration, physicians, nursing staff, and emergency department staff. This study will use inferential statistics to display a relationship between throughput times and how (LOS) and mortality rates correspond. The study location was a small community, for-profit hospital. This hospital has a 39 bed ED and has an yearly survey of 53,000 patient visits. All data will be collected from the facilities “Pulse” EHR.
The Inclusion Criteria of this study include Hospital admissions from the emergency department from the data period January 2015 to January 2018. The Exclusion Criteria include Behavioral Heath admissions (throughput times will be excluded, but will be included in emergency department census), Surgical holds (will count for department census only), Infusion patients (will count for department census only)
All information will be collected from the patients EHR such as ED disposition, hospital LOS, in hospital mortality, hospital census and bed availability will be considered. The times that are documented per patient are all input electronically by the emergency department staff to include admission time to the ED, bed assignment, and on floor arrival time.
For the purpose of Data Analysis, Descriptive and inferential statistics were used to analyze the association between throughput times of the ED and LOS, elevation of acuity, and mortality. This study was conducted with a 95% confidence interval the data was collected over the span of 3 years in order to prevent type 1 errors. To avoid type two error as large sample was collected to include data of 89,437 patients. All data was collected from the hospital EHR. All statistical data was produced from the same.
Investigations of hospital executives have described congestion in ED of hospitals in nearly every state and 91% of hospital executives report that excess numbers of people in ED is a major problem in hospitals. This issue has advanced due to numerous factors in the earlier 20 years, including a terminations of a large number of EDs and downsizing in capacity of hospitals. Studies determined the huge effect of crowding in EDs of the hospital which would eventually result in interruptions in dealing with patients and providing them with appropriate medicine. The study showed that patients admitted in hospitals with pneumonia from January, 2003 to April, 2005 in a single Emergency Department. The major conclusion we learned is that the delay was almost greater than 4 hours, to provide antibiotics for patients in the Emergency Department. 8 Emergency Department swarming methods were introduced for the first time. Bootstrapping and regression were adopted to examine the overall impact of Emergency department. Foreseen probabilities were also measured to actually find out about the enormousness of the influence of Emergency Department swarming on the likelihood of late or even no antibiotics at all. During this study the primary conclusion came out to be inpatient mortality while secondary consequences included many factors such a hospital costs and total length of stay.
Emergency department swarming has become a potential hindrance to getting appropriate emergency care in the United States. In spite of extensive acknowledgement of the problem, the research and policy needed to understand and address Emergency department crowding are just beginning to unfold. Its about that people realize that extraordinary crowding in emergency department would badly affect the patients, it would decrease effeeciency of staff, it would create a sense of disturbance for everyone involved. Times of extraordinary swarming in EDs of hospitals were associated with amplified inpatient mortality and growth in length of stay (LOS) and also on costs for admitted patients. Emergency Department swarming is also linked with delaying and lack of medicine in the Emergency Department for patients.
Derlet, R.W., Richards, J.R. Overcrowding in the nation’s emergency departments: complex causes and disturbing effects. Ann Emerg Med. 2000;35:63–68.
Lynn, S.G., Kellerman, A.L. Critical decision making: managing the emergency department in an overcrowded hospital. Ann Emerg Med. 1991;20:287–292.
Derlet, R., Richards, J., Kravitz, R. Frequent overcrowding in U.S. emergency departments. Acad Emerg Med. 2001;8:151–155.
Asplin, B., Magid, D., Rhodes, K., Solberg, L., Lurie, N., & Camargo, C. (2003). A conceptual model of emergency department crowding. Annals Of Emergency Medicine.
Sun, B., Hsia, R., Weiss, R., Zingmond, D., Liang, L., & Han, W. et al. (2013). Effect of Emergency Department Crowding on Outcomes of Admitted Patients. Annals Of Emergency Medicine.
Olshaker, J., & Rathlev, N. (2006). Emergency Department overcrowding and ambulance diversion: The impact and potential solutions of extended boarding of admitted patients in the Emergency Department. The Journal Of Emergency Medicine.