The Financial Impact of Ambulance Diversions and Patient Elopements

Falvo, Thomas; Grove, Lance; Stachura, Ruth; Zirkin, William

doi:10.1111/j.1553-2712.2007.tb00372.x

Cited by 38 publications

(19 citation statements)

References 15 publications

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“…Excessive patient overload also leads to decreased physician productivity [6][7][8] . Long ED holds across hospitals in the United States are proven to be decidedly correlated to higher patient length of stay (LOS) on inpatient care units [1,9,10] . Inability to transfer admitted patients to inpatient beds has been reported to be the most serious cause of ED overcrowding [2,11] .…”

Section: Introductionmentioning

confidence: 99%

A modular simulation study to improve patient flow to inpatient units in the emergency department

Norouzzadeh

Garber

Longacre

et al. 2014

JHA

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In this study, a modular discrete event simulation (computer modeling) has been presented to support process improvements in a hospital's emergency department (ED) to streamline admitted patient flow to inpatient units. Because the ED in this study has less than 10 beds, unnecessary occupation of beds affects the patient wait time dramatically. Additionally, ED overcrowding diminishes the quality of care, increases costs, and decreases employee and patient satisfaction. The modular simulation model evaluated the effectiveness of several recommended workflow improvements, resulting from comprehensive statistical analysis, based on their impact on cycle time and time traps in the process. The results suggested that, to ensure better efficiency and optimal cycle time, all of the suggested workflow improvements should be implemented simultaneously. The model also suggested that achieving customer satisfaction is possible 96.26% of the time with the current resource allocations in the ED.

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Section: Introductionmentioning

confidence: 99%

A modular simulation study to improve patient flow to inpatient units in the emergency department

Norouzzadeh

Garber

Longacre

et al. 2014

JHA

View full text Add to dashboard Cite

show abstract

“…3,[13][14][15] Anecdotal reports also exist suggesting that some ED staff prefer to divert patients when their waiting rooms are overcrowded, hoping that diverted patients will get care more rapidly at another facility. It has been reported that some hospitals prefer to divert ambulances in favor of their elective patients, in the interest of an improved payor mix and revenue collection; other reports demonstrate that ambulance patients actually provide financial benefit to the hospital.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Hospitals Diverting Ambulances in a California EMS System

Kahn

Stratton

Anderson

2014

Prehosp. Disaster med.

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“…In the second investigations, Falvo and colleagues reported in two separate papers on the cumulative financial impact of delay used data from 62,588 patient records collected over a 12 month period at a hospital in Pennsylvania [11,12]. In the first paper they estimated that the cumulative impact of ambulance diversion and "left without being seen" patients was $2.9 M [12].…”

Section: Discussionmentioning

confidence: 99%

“…In the first paper they estimated that the cumulative impact of ambulance diversion and "left without being seen" patients was $2.9 M [12]. In the second they estimated that 29% of admitted patients experienced delays in the ED, and that this translated to 10,397 lost treatment hours valued at $3.9 M [11].…”

Section: Discussionmentioning

confidence: 99%

The impact of delays to admission from the emergency department on inpatient outcomes

et al. 2010

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BackgroundWe sought to determine the impact of delays to admission from the Emergency Department (ED) on inpatient length of stay (LOS), and IP cost.MethodsWe conducted a retrospective analysis of 13,460 adult (≥ 18 yrs) ED visits between April 1 2006 and March 30 2007 at a tertiary care teaching hospital with two ED sites in which the mode of disposition was admission to ICU, surgery or inpatient wards. We defined ED Admission Delay as ED time to decision to admit > 12 hours. The primary outcomes were IP LOS, and total IP cost.ResultsApproximately 11.6% (n = 1558) of admitted patients experienced admission delay. In multivariate analysis we found that admission delay was associated with 12.4% longer IP LOS (95% CI 6.6% - 18.5%) and 11.0% greater total IP cost (6.0% - 16.4%). We estimated the cumulative impact of delay on all delayed patients as an additional 2,183 inpatient days and an increase in IP cost of $2,109,173 at the study institution.ConclusionsDelays to admission from the ED are associated with increased IP LOS and IP cost. Improving patient flow through the ED may reduce hospital costs and improve quality of care. There may be a business case for investments to reduce emergency department admission delays.

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The Financial Impact of Ambulance Diversions and Patient Elopements

Abstract: Significant revenue may be foregone as a result of throughput delays that prevent the ED from utilizing its existing bed capacity for additional patient visits.

Cited by 38 publications

References 15 publications

A modular simulation study to improve patient flow to inpatient units in the emergency department

A modular simulation study to improve patient flow to inpatient units in the emergency department

Characteristics of Hospitals Diverting Ambulances in a California EMS System

The impact of delays to admission from the emergency department on inpatient outcomes

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