Marked Increase in Patients Who Leave the ED without Treatment: A Troubling Byproduct of Some New ED Divert Policies

Implementation and evaluation of a ‘Navigator’ role to improve emergency department throughput

“…The cost of Australian acute healthcare is approximately $8 billion each year, rising annually well over the inflation rate, making government health budgets potentially unaffordable within 20 years [1]. A major issue for the health system is increasing demand and overcrowding of emergency departments (ED) [2], leading to access block (when patients in ED that require admission to hospital have a total ED time greater than 8 h) [3], congesting not only the ED but overall system operation, and impacting on patients and staff [4,5]. In this context, public health services are undergoing considerable change including reshaping their models of care delivery and, in some cases, redesigning or redesignating existing services and building new facilities.…”

“…ED crowding has been linked to staff stress [5], decreased staff satisfaction and retention [12], prolonged inpatient length of stay (LOS) [12,13] and financial implications [19,20]. Access block has been linked to increases in ED and hospital LOS, ambulance diversion, morbidity and mortality [4,5,12]. Many factors attributed to ED bed-block are hospital-or district-wide issues outside ED staff's control.…”