REDUCING PATIENT THROUGHPUT TIME IN EMERGENCY DEPARTMENTS BY RESOLVING BOTTLENECKS Dr. NAMITA MUKHI
INSTITUTE OF HEALTH MANAGEMENT RESEARCH
Reducing patient throughput time in emergency department by resolving bottlenecks Abstract
Background : With increasing number of accidents and disease spectrum in today’s time , emergency departments are frequently witnessing more patient’s visits . Increasing advent of health insurance has also directed increased utilisation of health care services . Yet under the surface , there is a growing crisis brewing in the emergency departments . Emergency departments are frequently overloaded , with patients sometimes lining the hallways and waiting hours and even days to be admitted to inpatient beds . Ambulance diversions in which the overcrowded emergency departments often close their doors to incoming patients has also become a common problem . Method : analysis of the time studies conducted on value added and non value added time of the patients being treated in the emergency department. Result : A patient’s throughput time is the total waiting time of the patient in the hospital. Starting as soon as they walk in through the doors of the emergency department and till the patient is discharged . A patient receives care by some critical steps which add value to their time but the waiting time between these essential steps is non value added time . Recommendations : Decreasing the non value added throughput time by identifying common bottlenecks in patient flow .Improvising and coordinating for meeting the increased demand of patients . Focussing on patient satisfaction by decreasing the throughput time . Identifying areas of bottlenecks in patient flow by mapping patient care and then improving upon timeliness of initial care , fast diagnostic procedures and speedy discharge . Forming a patient throughput management team or centre for centralised decision making and monitoring of smooth patient flow.
Background: With increase in number of accidents and disease spectrum , hospitals are witnessing bulk patient visits. Increasing advent of health insurance has also directed increased utilisation of health care services. There is a ratio of three patients per bed on an average in India . There is an ongoing crisis in catering to needs of patients by healthcare providers .Most of the patient admissions in hospitals are through emergency departments. Hospital emergency department provides medical treatment for a broad spectrum of illness and injuries to patients who arrive either in person or by ambulance. Emergency department (ED) or sometimes also called as casualty ward is the primary care department of a hospital that provides initial treatment to patients. It is an important entry point or ‘the front door’ or ‘the shop window’ of the hospital working round the clock. Hospital emergency departments are facing challenges due to increase in patients’ demand for their quality services. This resulting imbalance between the demand and capacity has lead to nation wide epidemic problems of emergency department crowding , boarding and ambulance diversion . As a result many a times it leads to patient dissatisfaction and tarnishes hospital image too. Crowding is most obvious manifestation of increased demand .It occurs not only because of increased number of patients coming in but also from inefficient discharge of patients creating a back log or old pool of patients . Consequently it leads to boarding that is holding the patient until an inpatient bed becomes available. Although the quality and efficient delivery of...