Table 8 Outcomes of patient flow improvement solutions

Proportion-related outcomes

Reduction of ED-LOS/Hospital LOS

[7, 15, 27, 31, 34, 35, 39, 55, 60,61,62,63,64, 66, 68, 69, 71,72,73,74, 76,77,78,79]

QAIM3

Reduction of Patients left without being seen (LWBS)/Did not wait (DNW)

[15, 27, 34, 35, 60, 64, 66, 68, 69, 72, 73]

QAIM1

Reduction of patients leaving against medical advice (LAMA)

[68, 72]

QAIM1

Access block reduction

[13, 15]

QAIM1, QAIM3

Meeting NEAT targets

[15, 73]

QAIM1, QAIM4

Manageable ED occupancy level

[39, 66, 74]

QAIM3

Decrease in Turnover Time (TOT)

[70]

QAIM3

Decrease in Turnaround Time (TAT)

[70]

QAIM3

Decrease in hospitalisations

[27, 74]

QAIM3

Decrease in admission rates

[33, 59, 65, 67, 71, 74]

QAIM3

Decrease in weekend ED attendances

[15]

QAIM2

Decrease in ED visits (ambulance admissions & self-referrals)

[15, 36, 68,69,70,71, 74, 76, 80]

QAIM3

Reduction In the number of Non-Urgent/Semi-Urgent/frequent users

[36, 73, 74]

QAIM2

Improvement of Discharge Rates

[34, 74]

QAIM3

Improvement of on-time starts (OTS)

[79]

QAIM3

Decrease in Readmission/Revisit Rates/Relapse

[34, 39, 61, 65,66,67, 71, 74, 79, 80]

QAIM3

Decrease in waiting time

[7, 39, 66, 73, 74, 76]

QAIM3

Reduction in ED transfer rate

[65, 73]

QAIM3

Decrease in Triage to ED Room/Bed Placement Time

[7, 66, 68, 76]

QAIM3

Decrease in door to physician time/time to Physician Initial Assessment

[7, 60, 62, 68, 69, 72, 76, 78]

QAIM3

Decrease in time to initiation of diagnostic testing

[72, 74]

QAIM3

Decrease in consult response time

[78]

QAIM3

Decrease in consultation to decision time

[27, 31, 66, 78]

QAIM1, QAIM1

Proportion of patients consulted

[78]

QAIM4

Decrease in physician to disposition decision time/ED workup time

[7, 69]

QAIM3

Reduced patient lead-time from registration to discharge

[73, 77, 79]

QAIM3

Decrease in Time-to-Treatment

[7, 15, 33, 61, 66, 72]

QAIM3

Decrease in ED boarding hours or time or count

[15, 34, 60, 66, 79]

QAIM3

Increase in patients transferred to inpatient bed

[15]

QAIM1, QAIM4

Number of patients diverted to primary care

[69, 70]

QAIM3

Cost-related outcomes

Lower costs

[60, 61, 64, 65, 68,69,70,71,72,73,74, 78, 79]

QAIM3

Resource utilisation

[74]

QAIM3

Process related outcomes

Reducing overcrowding

[13, 27, 39, 73, 76]

QAIM1

Enhanced throughput efficiency

[34]

QAIM3

Streamlined door-to-physician process

[35]

QAIM3

Enhanced referrals to community services

[59, 74]

QAIM2

Parental hospital visit satisfaction –

[57]

QAIM2

Reduction in hours of ambulance bypass/diversion

[15, 39, 66]

QAIM3

Enhanced patient access to ED

[34]

QAIM3

Decrease in the Emergency Department Work Index (EDWIN) score

[39]

QAIM3

Reducing ED utilisation

[36, 69, 73]

QAIM3

Patient or provider related outcomes

Improve the patient experience

[15, 32, 35, 39, 55, 57, 59, 63, 67,68,69, 72, 73, 76, 77, 79, 81]

QAIM1

Improved clinical experiences

[29, 76, 79]

QAIM4

Decrease in serious adverse event (e.g., mortality, ICU admission)

[15, 35, 39, 70,71,72]

QAIM2

Enhanced patient safety

[59, 69]

QAIM1

Improved health-related quality of care

[59]

QAIM1

Improvement in Patient's quality of life

[70]

QAIM1

Adherence to treatment

[57]

QAIM1, QAIM2

Decrease in potentially avoidable diagnostic tests and treatments

[72]

QAIM3

Reduction in medication errors

[39, 57, 74, 77]

QAIM1, QAIM4

Symptom relief

[33]

QAIM1

Reduced ED staff stress level

[15, 66]

QAIM4

Satisfaction of staff

[15, 59, 63, 72, 79]

QAIM4