title: Factors associated with exit block and impact on the emergency department.
abstract: We used routinely available data to identify the likelihood of exit block within type 1 EDs across acute trusts in England. While the findings are based on exploratory work and should be treated with caution, some patterns appeared to emerge from the data and require further exploration. NHS Trusts at risk of exit block were more likely to be large trusts, located in larger catchment areas, having higher admission rates and inpatient bed occupancy and higher levels of patients leaving the ED without being seen or reattending. Some of the factors identified may well be symptomatic of exit block rather than causal, while other factors may be acting as proxies for differences in casemix, social deprivation or ability to access alternative urgent care services.
authors.affiliation: Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Knowles
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Mason
authors.affiliation: The Medical School, University of Sheffield, Sheffield, UK.
authors.forename: Craig
authors.initials: C
authors.lastname: Smith
mesh_terms: D001509:Bed Occupancy; D003441:Crowding; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004739:England; D006297:Health Services Accessibility; D006801:Humans; D010343:Patient Admission; D012307:Risk Factors; D013997:Time Factors; D014850:Waiting Lists
keywords: emergency care systems, emergency departments; emergency department operations; performance improvement; quality