Advisory
Halving twelve-hour emergency stays across a hospital
AUD 52.9M
In funding, on this evidence base
Challenge
A major hospital was holding admitted patients in its emergency department for twelve hours or more, at rates that breached the national access target and blocked the department for new arrivals. The causes were spread across the whole hospital: discharge timing, ward bed availability, admission processes, specialty flows. The executive needed to know where patients were actually getting stuck, and what would move them.
Approach
We built a whole-of-hospital patient flow analysis from emergency, inpatient and bed-management data: hour-by-hour occupancy, length-of-stay distributions by specialty, admission and discharge timing, and the interactions between them. The analysis found the hospital typically had between thirty-three and forty-four empty beds at four in the afternoon while admitted patients waited in emergency, because discharges and admissions were out of phase. That finding drove a redesign of admission and discharge practice, developed with clinicians, and a measurement framework to track whether the change held.
Outcome
Patients spending twelve hours or more in the emergency department fell by more than half. Emergency cubicles occupied by admitted patients fell by 42 per cent. The most common emergency length of stay dropped from 165 to 135 minutes, and admission performance against the national access target rose from 32 to 39 per cent. The analysis became the evidence base for AUD 52.9 million in funding.
Source
Engagement record.
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