Unnecessary wait hours: a novel ED system-level metric.

Autor:	Heaton HA; Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA heaton.heather@mayo.edu., Nestler DM; Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA., Pasupathy KS; Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota, USA., Wutthisirisart P; Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota, USA., Sir MY; Mayo Clinic Department of Health Sciences Research, Rochester, Minnesota, USA., Hellmich TR; Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Jazyk:	angličtina
Zdroj:	Emergency medicine journal : EMJ [Emerg Med J] 2020 Sep; Vol. 37 (9), pp. 552-554. Date of Electronic Publication: 2020 Jun 22.
DOI:	10.1136/emermed-2019-208840
Abstrakt:	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 'Number of Unnecessary Waits (NUW)' and the corresponding '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. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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