Do elective surgical and medical admissions impact emergency department length of stay measurements?

Abstract

Background: Emergency department access block is a growing problem in emergency departments across Canada. Access block is defined as hospital occupancy >85% causing emergency department overcrowding. Hospital overcrowding leads to prolonged emergency department wait times, and delays in the transfer of admitted patients from the emergency department to inpatient beds. The relationship between elective admissions to hospital and emergency department wait times has not been adequately assessed. We undertook a simple linear regression analysis of the impact of elective admissions to hospital on emergency department length of stay. 
 
 Methods: Linear regression analysis of the number of daily elective admissions to adult acute care beds in the Calgary Health Region in the year 2004 and the daily median emergency department length of stay was done to establish the relationship between elective admissions and Emergency Department length of stay. 
 
 Results: 37,007 patients were admitted to adult acute care beds via the emergency department and 46,020 patients were admitted to adult acute care beds by all other routes. Regression analysis determined that there was no relationship between daily emergency department length of stay and the number of elective admissions per day. 
 
 Conclusion: For the year 2004, in the Calgary Health Region, elective acute care admissions to hospital had no relationship to emergency department length of stay for patients admitted via the emergency department. Further study is required to determine causative factors that prolong Emergency Department length of stay. Emergency departments across Canada continue to struggle with the demands of providing high quality care with diminishing resources.

External validation of the Rapid Assessment Prioritisation and Referral Tool for multidisciplinary teams in medical assessment and planning units

“…In addition to the aforementioned comparisons, the present study has made a novel contribution to understanding whether positive responses to the RAPaRT items are associated with important health service indicators . The sum of positive RAPaRT items was associated with longer lengths of stay and lesser likelihood of being discharged directly from MAPU without requirement for further inpatient care.…”

The ‘four‐hour target’ and the impact on Australian metropolitan acute surgical services

“…20 Further studies have postulated that ED overcrowding may be associated with the inappropriate treatment of patients in non-treatment areas (such as patients located on trolleys or in corridors). Unfortunately, the literature surrounding the focal effects of ED occupancy on acute surgical services is sparse.…”

Rounding frequency and hospital length of stay for children with respiratory illnesses: A simulation study

“…Although there have been numerous studies on ED crowding, its causes, and potential solutions, this study is the first to our knowledge to demonstrate differences in discharge timing between the ED and inpatient general care unit. High levels of hospital occupancy decrease patient flow in both ED and inpatient units . Shifting inpatient discharge for adult patients to earlier in the day can reduce or eliminate inpatient boarding in the ED .…”

“…High levels of hospital occupancy decrease patient flow in both ED and inpatient units. [21][22][23][24][25] Shifting inpatient discharge for adult patients to earlier in the day can reduce or eliminate inpatient boarding in the ED. 26,27 Evaluation of these relationships in pediatric populations are needed because of the unique care requirements of acutely ill children who often respond rapidly to hospital-based treatment.…”