title: Impact of a logistics management program on admitted patient boarders within an emergency department.
abstract: BACKGROUND
  ED crowding is a public health issue, and hospitals across the country must pursue aggressive strategies to improve patient flow to help solve this growing problem. The logistics management program (LMP) is an expansion of the bed management process to include a systematic approach to patient flow management throughout the facility and a clinical liaison or field agent to drive throughput at all points of care. The purpose of this study was to examine the effects of an LMP on ED length of stay (ED evaluation times and ED placement times), as well as inpatient length of stay (IPLOS).
  
  
  METHODS
  This is a quasi-experimental study of 28,684 ED admissions in a suburban, tertiary medical center before and after implementing an LMP (2008 vs 2009).
  
  
  RESULTS
  The median ED evaluation time was 219 minutes (interquartile range [IQR], 178 minutes) in 2008 versus 207 minutes (IQR, 171 minutes) in 2009 (P < .001). The median ED placement time was 219 minutes (IQR, 259 minutes) in 2008 versus 193 minutes (IQR, 158 minutes) in 2009 (P < .001). The median IPLOS was 3.93 days (IQR, 4.9 days) in 2008 versus 3.83 days (IQR, 4.7 days) in 2009 (P < .001), which represents a reduction of 1,483 inpatient days in 2009.
  
  
  CONCLUSIONS
  The results provide strong evidence to support the impact of an LMP on decreasing ED evaluation times, ED placement times, and IPLOS. Further exploration is needed to examine the program as a best practice, as well as its applicability for other facilities.
authors: Brooklyn, NY; Newark and Livingston, NJ; Philadelphia, PA. Electronic address: maryanne.healy@me.com.
authors: Mary Anne
authors: MA
authors: Healy-Rodriguez
authors: Brooklyn, NY; Newark and Livingston, NJ; Philadelphia, PA.
authors: Chris
authors: C
authors: Freer
authors: Brooklyn, NY; Newark and Livingston, NJ; Philadelphia, PA.
authors: Laura
authors: L
authors: Pontiggia
authors: Brooklyn, NY; Newark and Livingston, NJ; Philadelphia, PA.
authors: Rula
authors: R
authors: Wilson
authors: Brooklyn, NY; Newark and Livingston, NJ; Philadelphia, PA.
authors: Steve
authors: S
authors: Metraux
authors: Brooklyn, NY; Newark and Livingston, NJ; Philadelphia, PA.
authors: Lyndsey
authors: L
authors: Lord
mesh_terms: D003441:Crowding; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D018570:Risk Assessment; D013383:Suburban Population; D062606:Tertiary Care Centers; D014481:United States
keywords: ED boarders; ED holding; Logistics management program