Decreasing length of stay in the emergency department with a split emergency severity index 3 patient flow model.

Objectives: There has been a steady increase in emergency department (ED) patient volume and wait times. The desire to maintain or decrease costs while improving throughput requires novel approaches to patient flow. The break-out session "Interventions to Improve the Timeliness of Emergency Care" at the June 2011 Academic Emergency Medicine consensus conference "Interventions to Assure Quality in the Crowded Emergency Department" posed the challenge for more research of the split Emergency Severity Index (ESI) 3 patient flow model.

New directions in emergency service operations and planning.

Emergency services continue to evolve new operational and facility concepts in response to increasing demand for care and pressures for efficient, and safe, patient management. This article describes new models for "intake" of patients and for responding to peak demand that are radically changing the traditional emergency service. Application of Six Sigma and "Lean" analysis techniques are demonstrating dramatic improvements in throughput times and in the utilization of treatment spaces.

Improving patient flow in the emergency department.

To improve patient flow in the ED, hospitals should: Establish a measure of patient demand by hour, and design a system to handle it. Appropriately capacitate triage processes and systems. Use a system for patient segmentation and establish distinct processes for different patient segments.