System issues are at the heart of flow woes.
ED managers should be proactive in seeking to achieve Institute of Medicine report goals and in tackling patient flow from within, even before systems improvements are made. Change the "conversation" about flow, and address it in all meetings as a hospitalwide problem. Got no room for new patients? Try moving your admitted patients to the inpatient floor. Determine which areas "own" which part of the flow process, and then hold them accountable.
D003441:Crowding; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D010360:Patient Transfer / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D014481:United States