Emergency department patient flow: the influence of hospital census variables on emergency department length of stay.
OBJECTIVE
The objective was to evaluate the association between hospital census variables and emergency department (ED) length of stay (LOS). This may give insights into future strategies to relieve ED crowding.


METHODS
This multicenter cohort study captured ED LOS and disposition for all ED patients in five hospitals during five 1-week study periods. A stepwise multiple regression analysis was used to examine associations between ED LOS and various hospital census parameters.


RESULTS
Data were analyzed on 27,325 patients on 161 study days. A significant positive relationship was demonstrated between median ED LOS and intensive care unit (ICU) census, cardiac telemetry census, and the percentage of ED patients admitted each day. There was no relationship in this cohort between ED LOS and ED volume, total hospital occupancy rate, or the number of scheduled cardiac or surgical procedures.


CONCLUSIONS
In multiple hospital settings, ED LOS is correlated with the number of admissions and census of the higher acuity nursing units, more so than the number of ED patients each day, particularly in larger hospitals with busier EDs. Streamlining ED admissions and improving availability of inpatient critical care beds may reduce ED LOS.
Departments of Emergency Medicine, The George Washington University, Washington, DC, USA. rlucas@mfa.gwu.edu
Ray
R
Lucas
Heather
H
Farley
Joseph
J
Twanmoh
Andrej
A
Urumov
Nils
N
Olsen
Bruce
B
Evans
Hamed
H
Kabiri
D015331:Cohort Studies; D003441:Crowding; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D012044:Regression Analysis