Improving service in an emergency department by designing the health production flow
Background Most emergency departments have overcapacity with poor service measured by length of stay. We hypothesized that a formal design of the emergency department production flows will improve service. Thus, we propose a methodology that was tested in a large hospital, including new flow impleme...
Gespeichert in:
| Veröffentlicht in: | Health services management research 2020-05, Vol.33 (2), p.76-85 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 85 |
|---|---|
| container_issue | 2 |
| container_start_page | 76 |
| container_title | Health services management research |
| container_volume | 33 |
| creator | Barros, Oscar Riffo, Rodrigo Paredes, Inti |
| description | Background
Most emergency departments have overcapacity with poor service measured by length of stay. We hypothesized that a formal design of the emergency department production flows will improve service. Thus, we propose a methodology that was tested in a large hospital, including new flow implementation.
Results
We implemented new workflows during June to July 2017. A comparison of the patients’ average length of stay from June to September shows a decrease of 26%. Additionally, a comparison with 2016 shows a decrease of 50%. Direct evaluation of the value generated reveals an emergency department admissions increase of 540 monthly, equivalent of a savings of approximately US$250.000 annually. This savings is a very conservative estimate because the most significant value of this work is fast service that diminishes the patients’ risks.
Conclusions
Production design is an important problem in health services in terms of potential service improvements, executable with a formal, systemic, replicable method founded on several disciplines. Thus, we are replicating the approach at other hospitals with extensions to other services. |
| doi_str_mv | 10.1177/0951484819860325 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2385920942</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0951484819860325</sage_id><sourcerecordid>2385920942</sourcerecordid><originalsourceid>FETCH-LOGICAL-c365t-da8decde4efefb7237c5caa313e748b043d41b22f071f946dd2f56805b7258dc3</originalsourceid><addsrcrecordid>eNp1kM1Lw0AUxBdRbK3ePcmC5-h-ZjdHKX5BwUs9h83uS5rSbOpuUul_b0KrguDp8ZjfzMAgdE3JHaVK3ZNMUqGFpplOCWfyBE2pkjqhRIhTNB3lZNQn6CLGNSFE0zQ9RxNOmRKcZ1O0fG22od3VvsIRwq62gGuPjcfQQKjA2z12sDWha8B3uBi_WFd-5LsV4BWYTbfCQ4TrbVe3Hpeb9vMSnZVmE-HqeGfo_elxOX9JFm_Pr_OHRWJ5KrvEGe3AOhBQQlkoxpWV1hhOOSihCyK4E7RgrCSKlplInWOlTDWRAyu1s3yGbg-5Q_9HD7HL120f_FCZM65lxkgm2ECRA2VDG2OAMt-GujFhn1OSjzPmf2ccLDfH4L5owP0YvncbgOQARFPBb-u_gV_sTXrJ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2385920942</pqid></control><display><type>article</type><title>Improving service in an emergency department by designing the health production flow</title><source>Access via SAGE</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><creator>Barros, Oscar ; Riffo, Rodrigo ; Paredes, Inti</creator><creatorcontrib>Barros, Oscar ; Riffo, Rodrigo ; Paredes, Inti</creatorcontrib><description>Background
Most emergency departments have overcapacity with poor service measured by length of stay. We hypothesized that a formal design of the emergency department production flows will improve service. Thus, we propose a methodology that was tested in a large hospital, including new flow implementation.
Results
We implemented new workflows during June to July 2017. A comparison of the patients’ average length of stay from June to September shows a decrease of 26%. Additionally, a comparison with 2016 shows a decrease of 50%. Direct evaluation of the value generated reveals an emergency department admissions increase of 540 monthly, equivalent of a savings of approximately US$250.000 annually. This savings is a very conservative estimate because the most significant value of this work is fast service that diminishes the patients’ risks.
Conclusions
Production design is an important problem in health services in terms of potential service improvements, executable with a formal, systemic, replicable method founded on several disciplines. Thus, we are replicating the approach at other hospitals with extensions to other services.</description><identifier>ISSN: 0951-4848</identifier><identifier>EISSN: 1758-1044</identifier><identifier>DOI: 10.1177/0951484819860325</identifier><identifier>PMID: 31274339</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Averages ; Emergency services ; Health services ; Hospitalization ; Length of stay ; Savings</subject><ispartof>Health services management research, 2020-05, Vol.33 (2), p.76-85</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-da8decde4efefb7237c5caa313e748b043d41b22f071f946dd2f56805b7258dc3</citedby><cites>FETCH-LOGICAL-c365t-da8decde4efefb7237c5caa313e748b043d41b22f071f946dd2f56805b7258dc3</cites><orcidid>0000-0002-6535-3742</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0951484819860325$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0951484819860325$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,30999,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31274339$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barros, Oscar</creatorcontrib><creatorcontrib>Riffo, Rodrigo</creatorcontrib><creatorcontrib>Paredes, Inti</creatorcontrib><title>Improving service in an emergency department by designing the health production flow</title><title>Health services management research</title><addtitle>Health Serv Manage Res</addtitle><description>Background
Most emergency departments have overcapacity with poor service measured by length of stay. We hypothesized that a formal design of the emergency department production flows will improve service. Thus, we propose a methodology that was tested in a large hospital, including new flow implementation.
Results
We implemented new workflows during June to July 2017. A comparison of the patients’ average length of stay from June to September shows a decrease of 26%. Additionally, a comparison with 2016 shows a decrease of 50%. Direct evaluation of the value generated reveals an emergency department admissions increase of 540 monthly, equivalent of a savings of approximately US$250.000 annually. This savings is a very conservative estimate because the most significant value of this work is fast service that diminishes the patients’ risks.
Conclusions
Production design is an important problem in health services in terms of potential service improvements, executable with a formal, systemic, replicable method founded on several disciplines. Thus, we are replicating the approach at other hospitals with extensions to other services.</description><subject>Averages</subject><subject>Emergency services</subject><subject>Health services</subject><subject>Hospitalization</subject><subject>Length of stay</subject><subject>Savings</subject><issn>0951-4848</issn><issn>1758-1044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp1kM1Lw0AUxBdRbK3ePcmC5-h-ZjdHKX5BwUs9h83uS5rSbOpuUul_b0KrguDp8ZjfzMAgdE3JHaVK3ZNMUqGFpplOCWfyBE2pkjqhRIhTNB3lZNQn6CLGNSFE0zQ9RxNOmRKcZ1O0fG22od3VvsIRwq62gGuPjcfQQKjA2z12sDWha8B3uBi_WFd-5LsV4BWYTbfCQ4TrbVe3Hpeb9vMSnZVmE-HqeGfo_elxOX9JFm_Pr_OHRWJ5KrvEGe3AOhBQQlkoxpWV1hhOOSihCyK4E7RgrCSKlplInWOlTDWRAyu1s3yGbg-5Q_9HD7HL120f_FCZM65lxkgm2ECRA2VDG2OAMt-GujFhn1OSjzPmf2ccLDfH4L5owP0YvncbgOQARFPBb-u_gV_sTXrJ</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Barros, Oscar</creator><creator>Riffo, Rodrigo</creator><creator>Paredes, Inti</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><orcidid>https://orcid.org/0000-0002-6535-3742</orcidid></search><sort><creationdate>202005</creationdate><title>Improving service in an emergency department by designing the health production flow</title><author>Barros, Oscar ; Riffo, Rodrigo ; Paredes, Inti</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-da8decde4efefb7237c5caa313e748b043d41b22f071f946dd2f56805b7258dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Averages</topic><topic>Emergency services</topic><topic>Health services</topic><topic>Hospitalization</topic><topic>Length of stay</topic><topic>Savings</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barros, Oscar</creatorcontrib><creatorcontrib>Riffo, Rodrigo</creatorcontrib><creatorcontrib>Paredes, Inti</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><jtitle>Health services management research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barros, Oscar</au><au>Riffo, Rodrigo</au><au>Paredes, Inti</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improving service in an emergency department by designing the health production flow</atitle><jtitle>Health services management research</jtitle><addtitle>Health Serv Manage Res</addtitle><date>2020-05</date><risdate>2020</risdate><volume>33</volume><issue>2</issue><spage>76</spage><epage>85</epage><pages>76-85</pages><issn>0951-4848</issn><eissn>1758-1044</eissn><abstract>Background
Most emergency departments have overcapacity with poor service measured by length of stay. We hypothesized that a formal design of the emergency department production flows will improve service. Thus, we propose a methodology that was tested in a large hospital, including new flow implementation.
Results
We implemented new workflows during June to July 2017. A comparison of the patients’ average length of stay from June to September shows a decrease of 26%. Additionally, a comparison with 2016 shows a decrease of 50%. Direct evaluation of the value generated reveals an emergency department admissions increase of 540 monthly, equivalent of a savings of approximately US$250.000 annually. This savings is a very conservative estimate because the most significant value of this work is fast service that diminishes the patients’ risks.
Conclusions
Production design is an important problem in health services in terms of potential service improvements, executable with a formal, systemic, replicable method founded on several disciplines. Thus, we are replicating the approach at other hospitals with extensions to other services.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>31274339</pmid><doi>10.1177/0951484819860325</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-6535-3742</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0951-4848 |
| ispartof | Health services management research, 2020-05, Vol.33 (2), p.76-85 |
| issn | 0951-4848 1758-1044 |
| language | eng |
| recordid | cdi_proquest_journals_2385920942 |
| source | Access via SAGE; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Averages Emergency services Health services Hospitalization Length of stay Savings |
| title | Improving service in an emergency department by designing the health production flow |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T10%3A56%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Improving%20service%20in%20an%20emergency%20department%20by%20designing%20the%20health%20production%20flow&rft.jtitle=Health%20services%20management%20research&rft.au=Barros,%20Oscar&rft.date=2020-05&rft.volume=33&rft.issue=2&rft.spage=76&rft.epage=85&rft.pages=76-85&rft.issn=0951-4848&rft.eissn=1758-1044&rft_id=info:doi/10.1177/0951484819860325&rft_dat=%3Cproquest_cross%3E2385920942%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2385920942&rft_id=info:pmid/31274339&rft_sage_id=10.1177_0951484819860325&rfr_iscdi=true |