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Improving hospital flow ‘Ensiab Project’
Emergency department (ED) boarding is an indicator of less efficient hospital flow and is associated with longer inpatient length of stay, higher readmission rates and increased risk of mortality and medical errors. In addition to being associated with poor patient and staff satisfaction. This artic...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8479940/ https://www.ncbi.nlm.nih.gov/pubmed/34583936 http://dx.doi.org/10.1136/bmjoq-2021-001505 |
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author | Alotaibi, Yasser Alnowaiser, Noura Alamry, Ahmed |
author_facet | Alotaibi, Yasser Alnowaiser, Noura Alamry, Ahmed |
author_sort | Alotaibi, Yasser |
collection | PubMed |
description | Emergency department (ED) boarding is an indicator of less efficient hospital flow and is associated with longer inpatient length of stay, higher readmission rates and increased risk of mortality and medical errors. In addition to being associated with poor patient and staff satisfaction. This article describes the efforts of six tertiary care governmental hospitals in the Kingdom of Saudi Arabia that have enrolled in a collaborative improvement project to reduce ED boarding time. The hospitals implemented a multifaceted system intervention that included forming multidisciplinary flow improvement teams, implementing the National Health Service (NHS) SAFER patient flow bundle, visual management system and multidisciplinary ED bed huddles. By the end of the project, all hospitals significantly reduced ED boarding time with a pooled mean difference of – 7.1 hours (16.6 before, 9.5 hours after, p<0.001), reaching a pooled average of 2 hours in March 2020. Furthermore, by the end of the third learning session, all hospitals were able to achieve a boarding time below 6 hours. The enrolled hospitals also experienced an improvement in hospital flow process measures without any increase in 30-day readmission rates or bed occupancy rates. Our project demonstrates that implementing multifaceted system-wide interventions improves hospital flow and ED boarding time. Additionally, our project demonstrates a significant correlation between improvements in ED boarding time, daily consultant-led rounds and early discharge from inpatient units and time till discharge. |
format | Online Article Text |
id | pubmed-8479940 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-84799402021-10-14 Improving hospital flow ‘Ensiab Project’ Alotaibi, Yasser Alnowaiser, Noura Alamry, Ahmed BMJ Open Qual Quality Improvement Report Emergency department (ED) boarding is an indicator of less efficient hospital flow and is associated with longer inpatient length of stay, higher readmission rates and increased risk of mortality and medical errors. In addition to being associated with poor patient and staff satisfaction. This article describes the efforts of six tertiary care governmental hospitals in the Kingdom of Saudi Arabia that have enrolled in a collaborative improvement project to reduce ED boarding time. The hospitals implemented a multifaceted system intervention that included forming multidisciplinary flow improvement teams, implementing the National Health Service (NHS) SAFER patient flow bundle, visual management system and multidisciplinary ED bed huddles. By the end of the project, all hospitals significantly reduced ED boarding time with a pooled mean difference of – 7.1 hours (16.6 before, 9.5 hours after, p<0.001), reaching a pooled average of 2 hours in March 2020. Furthermore, by the end of the third learning session, all hospitals were able to achieve a boarding time below 6 hours. The enrolled hospitals also experienced an improvement in hospital flow process measures without any increase in 30-day readmission rates or bed occupancy rates. Our project demonstrates that implementing multifaceted system-wide interventions improves hospital flow and ED boarding time. Additionally, our project demonstrates a significant correlation between improvements in ED boarding time, daily consultant-led rounds and early discharge from inpatient units and time till discharge. BMJ Publishing Group 2021-09-28 /pmc/articles/PMC8479940/ /pubmed/34583936 http://dx.doi.org/10.1136/bmjoq-2021-001505 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Quality Improvement Report Alotaibi, Yasser Alnowaiser, Noura Alamry, Ahmed Improving hospital flow ‘Ensiab Project’ |
title | Improving hospital flow ‘Ensiab Project’ |
title_full | Improving hospital flow ‘Ensiab Project’ |
title_fullStr | Improving hospital flow ‘Ensiab Project’ |
title_full_unstemmed | Improving hospital flow ‘Ensiab Project’ |
title_short | Improving hospital flow ‘Ensiab Project’ |
title_sort | improving hospital flow ‘ensiab project’ |
topic | Quality Improvement Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8479940/ https://www.ncbi.nlm.nih.gov/pubmed/34583936 http://dx.doi.org/10.1136/bmjoq-2021-001505 |
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