Improving emergency department efficiency: a case study

13 November, 2014

New evidence shows hospitals can significantly improve efficiency and even bring down hospital mortality by refining their emergency department (ED) processes.

Published in the latest issue of the Australian Health Review, "Aiming to be NEAT: safely improving and sustaining access to emergency care in a tertiary referral hospital" details how Princess Alexandra Hospital in Queensland had doubled the number of ED patients discharged within four hours.

Through reforms to ED and hospital processes, Princess Alexandra Hospital was able to significantly improve the percentage of patients leaving the ED within four hours from 32 per cent to 62 per cent, while halving the average time in the ED from 7 hours to 3½.

ED efficiency and hospitality mortality

The report authors also established a link between the improved efficiency of the emergency department at Princess Alexandra Hospital and a decrease in overall hospital mortality from 2.3 per cent to 1.7 per cent.

"In highlighting the decrease in overall patient mortality at Princess Alexandra Hospital, we are able to see a correlation between the efficient treatment of those individuals that are lower on the triage scale and the freedom of time to spend on those patients requiring greater care," said report author, Dr Clair Sullivan.

"By discharging patients requiring a lower level of care, emergency department staff are able to provide a greater quality of care to those in need. 

"We have really focussed on making the process for emergency admission to our hospital more efficient and safer."

Lean thinking strategies

Australian Healthcare and Hospitals Association Chief Executive, Alison Verhoeven said the work being done at Princess Alexandra Hospital provided "important evidence" for emergency departments and inpatient teams seeking to improve overall performance.

"The improvement processes for emergency care instituted at Princess Alexandra Hospital exemplify the focus Australia's public hospitals have on efficiency and continuous quality improvement, including the implementation of Lean thinking strategies to drive change," Verhoeven said.

"Princess Alexandra Hospital is to be commended for this work."