Reduced access block causes shorter emergency department waiting times: An historical control observational study.
OBJECTIVE
To study the effect of changes in hospital occupancy and ED occupancy on ED waiting times during a 13-day period of improved bed access.


METHODS
A comparative, observational study of 1133 ED attendances in the study period and 2332 attendances in a historical control period.


RESULTS
During the study period, mean hospital occupancy decreased from 94.9% to 89.0% (P < 0.001), mean ED occupancy decreased from 19.1 to 14.8 patients (P < 0.001) and the mean ED waiting time decreased from 58.5 to 37.1 min (P < 0.001). There were statistically significant reductions in waiting times for patients in Australasian triage scale (ATS) categories 2-5. Departmental staffing levels, attendances and patient acuity were not significantly different during the study and control periods.


CONCLUSIONS
Modest decreases in hospital occupancy resulted in highly significant reductions in ED waiting times. Emergency department overcrowding due to large numbers of admitted patients awaiting hospital admission is a major cause of ED dysfunction.
Dunn
Robert
R
Emergency Department, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia. rdunn@mail.rah.sa.gov.au
D000328:Adult; D000368:Aged; D001315:Australia; D001509:Bed Occupancy; D004636:Emergency Service, Hospital / Q000592:standards; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies