The Effect of Emergency Department Expansion on Emergency Department Overcrowding

• DOI: 10.1197/j.aem.2006.12.005
• Publication Date: 2007-03-30T22:09:56Z
• Authors: Jin H. Han; Chuan Zhou; Daniel J. France; Sheng Zhong; Ian Jones; Alan B. Storrow; Dominik Aronsky
• Keywords: Overcrowding; Trauma Center

To examine the effects of emergency department (ED) expansion on ambulance diversion at an urban, academic Level 1 trauma center.This was a pre-post study performed using administrative data from ED and hospital electronic information systems. On April 19, 2005, adult expanded 28 to 53 licensed beds. Data five-month pre-expansion period (November 1, 2004, March 2005) postexpansion (June October 31, were included for this analysis. waiting room statistics as well status obtained. Total length stay (LOS) defined time patient registration leaving ED. Admission hold LOS inpatient bed request admitted patients. Mean differences (95% confidence interval [CI]) in total spent per month, episodes duration episode calculated. An accelerated failure model test if associated with reduction while adjusting potential confounders.From postexpansion, daily volume increased but occupancy decreased. There no significant change month (mean difference, 10.9 hours; 95% CI = -74.0 95.8), (two month; -4.2 8.2), (0.3 -4.0 3.5). (+/-SD) 4.6 (+/-1.9) 5.6(+/-2.3) hours, mean admission also 3.0 (+/-0.2) 4.1 hours. The proportion patients who left without being seen 3.5% 2.7% (p 0.06) periods, respectively. In model, did not affect next episode.An increase capacity diversion. Instead, increased. As result, appears be insufficient solution improve addressing other bottlenecks hospital.