title: Patient throughput times and inflow patterns in Swedish emergency departments. A basis for ANSWER, A National SWedish Emergency Registry.
abstract: OBJECTIVE
  Quality improvement initiatives in emergency medicine (EM) often suffer from a lack of benchmarking data on the quality of care. The objectives of this study were twofold: 1. To assess the feasibility of collecting benchmarking data from different Swedish emergency departments (EDs) and 2. To evaluate patient throughput times and inflow patterns.
  
  
  METHODS
  We compared patient inflow patterns, total lengths of patient stay (LOS) and times to first physician at six Swedish university hospital EDs in 2009. Study data were retrieved from the hospitals' computerized information systems during single on-site visits to each participating hospital.
  
  
  RESULTS
  All EDs provided throughput times and patient presentation data without significant problems. In all EDs, Monday was the busiest day and the fewest patients presented on Saturday. All EDs had a large increase in patient inflow before noon with a slow decline over the rest of the 24 h, and this peak and decline was especially pronounced in elderly patients. The average LOS was 4 h of which 2 h was spent waiting for the first physician. These throughput times showed a considerable diurnal variation in all EDs, with the longest times occurring 6-7 am and in the late afternoon.
  
  
  CONCLUSIONS
  These results demonstrate the feasibility of collecting benchmarking data on quality of care targets within Swedish EM, and form the basis for ANSWER, A National SWedish Emergency Registry.
authors.affiliation: Emergency Medicine, Department of Clinical Sciences at Lund, Lund University, Lund, Sweden. ulf.ekelund@med.lu.se
authors.forename: Ulf
authors.initials: U
authors.lastname: Ekelund
authors.forename: Lisa
authors.initials: L
authors.lastname: Kurland
authors.forename: Fredrik
authors.initials: F
authors.lastname: Eklund
authors.forename: Paulus
authors.initials: P
authors.lastname: Torkki
authors.forename: Anna
authors.initials: A
authors.lastname: Letterstål
authors.forename: Per
authors.initials: P
authors.lastname: Lindmarker
authors.forename: Maaret
authors.initials: M
authors.lastname: Castrén
mesh_terms: D000328:Adult; D000368:Aged; D019985:Benchmarking / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D012042:Registries; D012189:Retrospective Studies; D013548:Sweden