Table 5 Human factor interventions for patient flow improvement

Training and professional development

-Triage education [30]

 + 

- Training for healthcare workers [29, 35, 72, 78]

 ± 

 ± 

- Long-term care facility staff education [65]

 = 

- Hospital education to increase awareness of targets prior to implementation [15]

 + 

 + 

- Creating a supportive work environment to facilitate role development [77]

 + 

 + 

- Creation of new dedicated professional Figs. [72]

 + 

 + 

Physician-directed interventions

- GP integration in ED for nonurgent care [27, 30, 61, 62, 69]

 ± 

- Physician-led ED triage models [7, 15, 27, 30, 35, 55, 64, 75, 78]

 ± 

- GP Onsite Availability (Next to ED) [30, 69]

 + 

- Dedicated neurologist in ED [64]

 + 

- Geriatrician embedded within the ED [66]

 + 

Nurse-directed interventions

- Nurse-led triage service [7, 30, 76]

 ± 

- ED nurse practitioner employment [27, 66]

 ± 

- Qualified nurse for assessment, diagnosis, and treatment [7, 15, 76]

 ± 

- Advanced practice nurses (clinical nurse specialist, certified registered nurse anaesthetists, clinical initiatives nurse) [7, 15, 76]

 ± 

- Nurse-initiated request for paramedical service/- Triage nurse ordering (TNO) requests [7, 15, 27, 33, 64, 69]

 ± 

- Integration of advanced nursing care in long-term care facilities [71]

 + 

- Implementation of ED ambulance offload nurse role [66]

 + 

Staffing Adjustments

- Changing staffing [7, 39, 72]

 ± 

- Increasing the numbers of staff [7, 13, 15, 75]

 ± 

- Modification of staffing patterns (staff types or mix) [7, 13, 31, 72, 75]

 ± 

- Relocating doctors and nurses already assigned to triage in the rapid evaluation unit (RAU) [72]

 + 

- Optimised Staff Responsibilities [7, 13, 75]

 ± 

- Interventions relating to Physiotherapy Roles in ED [30]

NR

- Interventions relating to Pharmacy Roles in ED [30]

 + 

- Dedicated ED radiology staff [7]

 + 

- Motivation, Payment models and strategies (Physician Transition to Fee-For-Service Payment, Resident health status Medicare incentives, financial incentives for PCPs and GPs) [36, 64, 65, 69, 75]

 ± 

- Implementing financial disincentives for nonemergency presentations, as referred by primary health care clinics [15]

 + 

- Introduction of a team of full-time emergency medicine doctors in the ED [35]

 ± 

- Scribes [7, 63, 64]

 ± 

 ± 

Patient education

- Patient education by means of printed material or personal contact [13]

NR

NR

- Public education campaigns on proper use of ED [15]

 + 

 + 

- Family education [13]

NR