Analysis and improvement of patient turnaround time in an Emergency Department

Decreases in available hospital Emergency Departments (EDs) combined with increases in the number of patients visiting the ED are creating significant challenges for hospital EDs nationwide. Increased attention is being placed on patient turnaround time (TAT), as longer patient stays result in higher costs for the ED and lower patient satisfaction, especially when compounded by increasing patient volume. Hospitals around the world are applying a systems engineering approach to resolve these problems. This paper describes an effort to reduce TAT in the ED of a medium-sized hospital. Along with literature review, a number of tools were used to analyze the ED, including a survey questionnaire, interviews, direct observation, and analysis of archival process data. Examples of problem areas identified include handoffs and communication between the ED and other departments and patient flow through the ED. Based on analysis findings, recommendations for improvement have been identified which include a point-of-care Laboratory testing station, a saturation level assessment system, and an in-room Kanban supply replenishment system,. Implementation of these changes is expected to significantly reduce patient TAT and patient costs in the ED.