Table 7 Infrastructure interventions for patient flow improvement

Buildings and structures

Buildings

- Acute Medical Units (AMU) for community inpatient care [27]

 + 

- Acute care unit within ED to receive patients who need inpatient services from the ED [30]

 + 

 + 

- Establishing the adjacent/colocated primary care clinic for lower acuity patients [69]

NR

NR

- Rapid assessment zones for expedited patient evaluation and treatment [7, 13, 27, 30]

 ± 

- Short Stay Units (SSUs) for streamlined ED patient care [7, 13, 27, 30]

 ± 

 ± 

- Alternative Free Standing Emergency Departments (FSEDs) [58]

NR

- Opening additional EDs [75]

NR

- Implementing GP-led walk-in centres and colocating GPs [57]

 = 

 = 

Physical structures

- Increasing the numbers of beds or freeing beds [13, 34, 72, 75]

 ± 

 ± 

- Reclining hospital chair [32]

 + 

- Increasing the size of EDs [13, 34]

 = 

- Hallway emergency bed policy (reorganisation of internal spaces for first patient evaluation using hallway beds/chairs) [72, 75]

 ± 

- Provision of patient lounges to support admission-discharge patient flow (Transit lounges) [34]

 + 

 + 

- Allocating financial resources for patient flow enhancement [34]

NR

NR

NR

NR

Technology/Innovation

Telehealth

- Telemedicine triage/Online ‘pre-ED’ triaging [13, 64]

 ± 

- Telehealth care service/virtual care/visit systems [13, 35, 65, 71]

 ± 

 ± 

Technology/Innovation

Information Technology (IT)

- Clinical Decision Support Systems (CDSS) [29, 30, 65, 73]

NR

NR

- Web-based dashboards and reporting applications to provide real-time information and monitor patient flow [29, 73, 75]

NR

NR

- Implementing community-based Regional Transfer Network System (RTNS) [75]

 + 

 + 

- Using capacity alert escalation call [75]

 + 

 + 

- Mobile Devices [30]

NR

- Computerised Provider Order Entry (CPOE) [7, 35, 64]

 ± 

 ± 

- Integrated ED Information System [35]

NR

- Implementation of simulation and predictive models/Discrete event simulation (DES)/predictive tool [29, 30, 35, 72, 73, 75]

NR

NR

- Electronic board tracking/electronic patient tracking systems/electronic Blockage System (EBS) [7, 15, 34, 35, 64, 75]

 + 

 + 

- Leverage machine algorithm learning [29, 73]

NR

NR

- AI-powered automatic patient‒physician assignment [64]

NR

- Implementing a random monitoring system of the ambulance block [72]

NR

NR

- Telephone consultations [65]

NR

- SMS reminder to consultant/residents about consultation delays [15, 31, 78]

NR

- Use of instant messaging (e.g., WhatsApp) for real-time communication between ED physicians and consultants [78]

 + 

- Electronic Health Records (EHR) Access [30, 60, 64, 72]

NR