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2015 ; 4
(ä): 38
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Organizational factors affecting length of stay in the emergency department:
initial observational study
#MMPMID26473027
Bashkin O
; Caspi S
; Haligoa R
; Mizrahi S
; Stalnikowicz R
Isr J Health Policy Res
2015[]; 4
(ä): 38
PMID26473027
show ga
BACKGROUND: Length of stay (LOS) is considered a key measure of emergency
department throughput, and from the perspective of the patient, it is perceived
as a measure of healthcare service quality. Prolonged LOS can be caused by
various internal and external factors. This study examined LOS in the emergency
department and explored the main factors that influence LOS and cause delay in
patient care. METHODS: Observations of 105 patients were performed over a 3-month
period at the emergency room of a community urban hospital. Observers monitored
patients from the moment of entrance to the department until discharge or
admission to another hospital ward. RESULTS: Analysis revealed a general average
total emergency department LOS of 438 min. Significant differences in average LOS
were found between admitted patients (Mean?=?544 min, SD?=?323 min) and
discharged patients (Mean?=?291 min, SD?=?286 min). In addition, nurse and
physician change of shifts and admissions to hospital wards were found to be
significant factors associated with LOS. Using an Ishikawa causal diagram, we
explored various latent organizational factors that may prolong this time.
CONCLUSIONS: The study identified several factors that are associated with high
average emergency department LOS. High LOS may lead to increases in expenditures
and may have implications for patient safety, whereas certain organizational
changes, communication improvement, and time management may have a positive
effect on it. Interdisciplinary methods can be used to explore factors causing
prolonged emergency department LOS and contribute to a better understanding of
them.