title: Process Improvements to Reform Patient Flow in the Emergency Department.
abstract: Emergency departments (ED) function to diagnose, stabilize, manage and dispose patients as efficiently as possible. Although problems may be suspected at triage, ED physician input is required at each step of the patient journey through the ED, from diagnosis to disposition. If we want timely diagnosis, appropriate treatment and great outcomes, then ED processes should connect patients and physicians as quickly as possible. This article discusses the key concepts of ED patient flow, value and efficiency. Based on these fundamentals, it describes the significant impact of ED process improvements implemented on measures of ED efficiency at a large community ED in Ontario, Canada.
authors.affiliation: Author of No More Lethal Waits - 10 Steps to Transform Canada's Emergency Departments, BPS Books, Toronto, 2016. He served as physician leader (aka medical program director) of the Emergency Medicine Program at Southlake Regional until 2014. Shawn is a lecturer in the Department of Family and Community Medicine, University of Toronto, and assistant clinical professor (adjunct) in the Department of Family Medicine, McMaster University.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Whatley
authors.affiliation: Resident in Family Medicine at Queen's University. He is interested in pursuing a career in emergency medicine. He has research interests in emergency department operations, and improving access to primary care.
authors.forename: Alexander K
authors.initials: AK
authors.lastname: Leung
authors.affiliation: Last 20 years been the chief of three large emergency departments in Toronto and consulted on patient flow in hospitals across Canada and for the National Health Service in the UK. He presents regularly at CAEP, WEDOC, and other national conferences. He is an Assistant Professor in the Department of Family and Community Medicine, University of Toronto.
authors.forename: Marko
authors.initials: M
authors.lastname: Duic
mesh_terms: D003151:Community Health Centers; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D009726:Nurses / Q000706:statistics & numerical data; D009864:Ontario; D010361:Patients / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data; D013997:Time Factors; D014218:Triage / Q000458:organization & administration*; D057188:Workflow; D000078329:Workforce