Reducing Length of Stay in the Emergency Department

NCT03185533 | Completed DMC

• 1 other identifier: 105-061-E
• Study Type: observational
• Target: 72,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

Emergency department (ED) crowding has become an international challenge in the recent decades. Length of stay (LOS) is a useful marker to monitor ED crowding. Searching for the possible causes and reducing barriers may have the greatest impact on EDLOS. Therefore, the investigators assembled a multidisciplinary team for improvement of the ED process, to undergo assessments of ED patient flow with the spirit of lean-sigma methodologies. The objectives of this study were to evaluate a Lean-sigma-based initiative to lessen EDLOS.

Conditions

Length of Stay

Outcome Measures

Primary Outcomes (1)

• length of stay for ED admissions.

  Length of stay was defined as the time from patient registration to leaving the ED.

  12 months

Secondary Outcomes (3)

• boarding time for ED admissions

  12months

• decision time for ED admissions

  12 months

• the percentage of LOS over 24 hours in all ED patients.

  12 months

Study Arms (1)

to reduce ED length of stay

to reduce ED length of stay to lessen ED crowding by using Lean-sigma management and quality improvement interventions including reducing boarding time and medical decision time.

Behavioral: Quality improvement (QI) interventions

Interventions

Quality improvement (QI) interventions BEHAVIORAL

1\. The ED admissions exhibited prolonged length of stay. 2\. The Interventions for Reducing Medical Decision Time: 1. The ED director created QI education sessions and reported monthly QI outcomes. 2. The ED nurses reported the current number of ED admission patients twice a day to the director. The director summarized the bed requests to the administrative personnel. 3. The nurses reported the in-scene complicated cases to the ED director. The director would give an assistance in managing these cases. 3\. The Interventions for Reducing Boarding Time 1. The ED patients could be admitted before 8 a.m. if the bed was vacant. 2. The ED director initiated an on-line meeting at 8 a.m. and 4 p.m. 3. Monthly QI outcomes were reported in the hospital affairs meeting.

to reduce ED length of stay

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The patients were registered in the ED of the Hsin-Chu branch from Jan, 2015 to Dec, 2015.

You may qualify if:

• the patients were registered in the ED from Jan, 2015 to Dec, 2015.

You may not qualify if:

• the patients were excluded because of left without seeing a physician.

Sponsors & Collaborators

• National Taiwan University Hospital Hsin-Chu Branch: lead

MeSH Terms

Interventions

Quality Improvement; Methods

Intervention Hierarchy (Ancestors)

Engineering; Technology, Industry, and Agriculture; Quality of Health Care; Health Services Administration; Investigative Techniques

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director, Department of Emergency Medicine, NTUH Hsin-Chu branch

Study Record Dates

• First Submitted: June 4, 2017
• First Posted: June 14, 2017
• Study Start: January 1, 2015
• Primary Completion: December 31, 2015
• Study Completion: December 31, 2015
• Last Updated: June 14, 2017

Record last verified: 2017-06

Data Sharing

• IPD Sharing: Will share