Effectiveness of Emergency Medicine Wards in reducing length of stay and overcrowding in emergency departments.
OBJECTIVE
This study aims to evaluate the effectiveness of an Emergency Medicine Ward (EMW) in reducing the length of stay (LOS) in the emergency department, length of hospitalization, emergency medical admission rate, and the hospital bed occupancy rate.


METHODS
This study is a cross-sectional, observational study with a retrospective, quantitative record review conducted at the EMW of a regional acute hospital in Hong Kong from January 2009 to June 2009.


RESULTS
During the study, a retrospective audit was conducted on 1834 patient records. The five main groups of patients admitted into EMW suffered from cardiac disease (26.5%), pneumonia (19.6%), dizziness (16.2%), Chronic Obstructive Pulmonary Disease (12.3%), and gastroenteritis (7.9%). The mean LOS in the EMW was 1.27 days (SD=0.59). The average emergency medical admission rate within the six-month period was significantly reduced relative to that before the EMW became operational (January 2008 to June 2008). Clinically, the medical in-patient bed occupancy was significantly reduced by 6.2%. The average LOS during in-patient hospitalization after the EMW was established decreased to 4.13 days from the previous length of 5.16 days.


CONCLUSIONS
EMWs effectively reduce both the LOS during in-patient hospitalization and the avoidable medical admission rate.
Emergency Department, Alice Ho Miu Ling Nethersole Hospital, Tai Po, New Territories, Hong Kong Special Administrative Region. Electronic address: losm1@ha.org.hk.
Shuk Man
SM
Lo
Emergency Department, Tuen Mun Hospital, New Territories West, Hong Kong Special Administrative Region.
Kenny Tze Ying
KT
Choi
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Eliza Mi Ling
EM
Wong
Emergency Department, Alice Ho Miu Ling Nethersole Hospital, Tai Po, New Territories, Hong Kong Special Administrative Region.
Larry Lap Yip
LL
Lee
Emergency Department, Alice Ho Miu Ling Nethersole Hospital, Tai Po, New Territories, Hong Kong Special Administrative Region.
Richard Sai Dat
RS
Yeung
Emergency Department, Alice Ho Miu Ling Nethersole Hospital, Tai Po, New Territories, Hong Kong Special Administrative Region.
Jimmy Tak Shing
JT
Chan
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Sek Ying
SY
Chair
D000368:Aged; D003430:Cross-Sectional Studies; D003441:Crowding; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006723:Hong Kong; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies
Effectiveness; Emergency Department; Emergency Medicine Ward; Length of stay; Overcrowding; Service development