TY - JOUR
T1 - Unnecessary wait hours
T2 - A novel ED system-level metric
AU - Heaton, Heather A.
AU - Nestler, David M.
AU - Pasupathy, Kalyan S.
AU - Wutthisirisart, Phichet
AU - Sir, Mustafa Y.
AU - Hellmich, Thomas R.
N1 - Funding Information:
Funding This study was supported by funds from the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery and contributions from the Mayo Clinic Emergency Department–Clinical Engineering Learning Laboratory.
Publisher Copyright:
© 2020 BMJ Publishing Group. All rights reserved.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background Emergency department (ED) operations leaders are under increasing pressure to make care delivery more efficient. Publicly reported ED efficiency metrics are traditionally patient centred and do not show situational or facility-based improvement opportunities. We propose the consideration of a novel metric, the a € Number of Unnecessary Waits (NUW)' and the corresponding a € Unnecessary Wait Hours (UWH)', to measure space efficiency, and we describe how we used NUW to evaluate operational changes in our ED. Methods UWH summarises the relationship between the number of available rooms and the number of patients waiting by returning a value equal to the number of unnecessary patient waits. We used this metric to evaluate reassigning a clinical technician assistant (CTA) to the new role of flow CTA. Results We retrospectively analysed 3.5 months of data from before and after creation of the flow CTA. NUW metric analysis suggested that the flow CTA decreased the amount of unnecessary wait hours, while higher patient volumes had the opposite effect. Conclusions Situational system-level metrics may provide a new dimension to evaluating ED operational efficiencies. Studies focussed on system-level metrics to evaluate an ED practice are needed to understand the role these metrics play in evaluation of a department's operations.
AB - Background Emergency department (ED) operations leaders are under increasing pressure to make care delivery more efficient. Publicly reported ED efficiency metrics are traditionally patient centred and do not show situational or facility-based improvement opportunities. We propose the consideration of a novel metric, the a € Number of Unnecessary Waits (NUW)' and the corresponding a € Unnecessary Wait Hours (UWH)', to measure space efficiency, and we describe how we used NUW to evaluate operational changes in our ED. Methods UWH summarises the relationship between the number of available rooms and the number of patients waiting by returning a value equal to the number of unnecessary patient waits. We used this metric to evaluate reassigning a clinical technician assistant (CTA) to the new role of flow CTA. Results We retrospectively analysed 3.5 months of data from before and after creation of the flow CTA. NUW metric analysis suggested that the flow CTA decreased the amount of unnecessary wait hours, while higher patient volumes had the opposite effect. Conclusions Situational system-level metrics may provide a new dimension to evaluating ED operational efficiencies. Studies focussed on system-level metrics to evaluate an ED practice are needed to understand the role these metrics play in evaluation of a department's operations.
KW - emergency department
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U2 - 10.1136/emermed-2019-208840
DO - 10.1136/emermed-2019-208840
M3 - Article
C2 - 32571784
AN - SCOPUS:85087565149
SN - 1472-0205
VL - 37
SP - 552
EP - 554
JO - Emergency Medicine Journal
JF - Emergency Medicine Journal
IS - 9
ER -