At The Forefront

Matching Emergency Department (ED) capacity to demand is a complex and critical challenge that healthcare systems face nationally. Additionally, the role of the ED within the community is evolving away from the traditional model to that of an advanced diagnostic center. Several factors, including patient influx variability, staffing issues, resource limitations, and systemic inefficiencies, contribute to this difficulty. Perhaps the greatest predictor of an over-crowded ED is an over-crowded hospital.  “Bed-boarded” patients seriously impact the most constraining variables that influence the ability to match capacity and demand: treatment space and staff.  While this seems to be a daunting challenge, an ED is a system, and when managed as a complex adaptive system, dramatic performance improvement is possible.  The concept of a wait-free ED is not beyond the realm of possibility.  This edition of At The Forefront explains the concepts involved.