Achieving Efficiency in Crowded Emergency Departments: A Research Agenda

Authors

  • Michael J. Ward MD, MBA,

    1. From the Department of Emergency Medicine, University of Cincinnati (MJW), Cincinnati, OH; the Department of Emergency Medicine, Christiana Care Health System (HF), Wilmington, DE; the Department of Emergency Medicine, Institute for Healthcare Studies, Northwestern University (RHK), Chicago, IL; the Department of Emergency Medicine, Advocate Christ Medical Center (EK), Oak Lawn, IL; the Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality (AHRQ) (RLM), Washington, DC; the Department of Emergency Medicine, George Washington University (RS), Washington, DC; and the Emergency Nurses Association (SS), Des Plaines, IL.
    Search for more papers by this author
  • Heather Farley MD,

    1. From the Department of Emergency Medicine, University of Cincinnati (MJW), Cincinnati, OH; the Department of Emergency Medicine, Christiana Care Health System (HF), Wilmington, DE; the Department of Emergency Medicine, Institute for Healthcare Studies, Northwestern University (RHK), Chicago, IL; the Department of Emergency Medicine, Advocate Christ Medical Center (EK), Oak Lawn, IL; the Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality (AHRQ) (RLM), Washington, DC; the Department of Emergency Medicine, George Washington University (RS), Washington, DC; and the Emergency Nurses Association (SS), Des Plaines, IL.
    Search for more papers by this author
  • Rahul K. Khare MD, MS,

    1. From the Department of Emergency Medicine, University of Cincinnati (MJW), Cincinnati, OH; the Department of Emergency Medicine, Christiana Care Health System (HF), Wilmington, DE; the Department of Emergency Medicine, Institute for Healthcare Studies, Northwestern University (RHK), Chicago, IL; the Department of Emergency Medicine, Advocate Christ Medical Center (EK), Oak Lawn, IL; the Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality (AHRQ) (RLM), Washington, DC; the Department of Emergency Medicine, George Washington University (RS), Washington, DC; and the Emergency Nurses Association (SS), Des Plaines, IL.
    Search for more papers by this author
  • Erik Kulstad MD, MS,

    1. From the Department of Emergency Medicine, University of Cincinnati (MJW), Cincinnati, OH; the Department of Emergency Medicine, Christiana Care Health System (HF), Wilmington, DE; the Department of Emergency Medicine, Institute for Healthcare Studies, Northwestern University (RHK), Chicago, IL; the Department of Emergency Medicine, Advocate Christ Medical Center (EK), Oak Lawn, IL; the Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality (AHRQ) (RLM), Washington, DC; the Department of Emergency Medicine, George Washington University (RS), Washington, DC; and the Emergency Nurses Association (SS), Des Plaines, IL.
    Search for more papers by this author
  • Ryan L. Mutter PhD,

    1. From the Department of Emergency Medicine, University of Cincinnati (MJW), Cincinnati, OH; the Department of Emergency Medicine, Christiana Care Health System (HF), Wilmington, DE; the Department of Emergency Medicine, Institute for Healthcare Studies, Northwestern University (RHK), Chicago, IL; the Department of Emergency Medicine, Advocate Christ Medical Center (EK), Oak Lawn, IL; the Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality (AHRQ) (RLM), Washington, DC; the Department of Emergency Medicine, George Washington University (RS), Washington, DC; and the Emergency Nurses Association (SS), Des Plaines, IL.
    Search for more papers by this author
  • Robert Shesser MD,

    1. From the Department of Emergency Medicine, University of Cincinnati (MJW), Cincinnati, OH; the Department of Emergency Medicine, Christiana Care Health System (HF), Wilmington, DE; the Department of Emergency Medicine, Institute for Healthcare Studies, Northwestern University (RHK), Chicago, IL; the Department of Emergency Medicine, Advocate Christ Medical Center (EK), Oak Lawn, IL; the Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality (AHRQ) (RLM), Washington, DC; the Department of Emergency Medicine, George Washington University (RS), Washington, DC; and the Emergency Nurses Association (SS), Des Plaines, IL.
    Search for more papers by this author
  • Suzanne Stone-Griffith RN

    1. From the Department of Emergency Medicine, University of Cincinnati (MJW), Cincinnati, OH; the Department of Emergency Medicine, Christiana Care Health System (HF), Wilmington, DE; the Department of Emergency Medicine, Institute for Healthcare Studies, Northwestern University (RHK), Chicago, IL; the Department of Emergency Medicine, Advocate Christ Medical Center (EK), Oak Lawn, IL; the Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality (AHRQ) (RLM), Washington, DC; the Department of Emergency Medicine, George Washington University (RS), Washington, DC; and the Emergency Nurses Association (SS), Des Plaines, IL.
    Search for more papers by this author

  • Working group participants were as follows (in alphabetical order): James Amsterdam, Hany Atallah, Chandra Aubin, John Becher, Theodore Christopher, Karen Cosby, Ru Ding, Heather Farley, Christina Gindele, Jason Hack, Kurt Isenberger Ray Johnson, John Kelly, Rahul Khare, Erik Kulstad, Lawrence Melniker, Ryan L. Mutter, Howard Ovens, Jesse M. Pines, Peter Samuel, Caitlin Schaninger, Robert Shesser, Dell Simmons, Jeffrey Smith, Robert Solomon, Suzanne Stone-Griffith, Michael J. Ward, Robert Wears, and Lainie Yarris.

  • Funding for this conference was made possible (in part) by 1R13HS020139-01 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. This issue of Academic Emergency Medicine is funded by the Robert Wood Johnson Foundation.

  • This paper does not represent the policy of either the Agency for Healthcare Research and Quality (AHRQ) or the U.S. Department of Health and Human Services (DHHS). The views expressed herein are those of the authors and no official endorsement by AHRQ or DHHS is intended or should be inferred.

  • The authors have no potential conflicts of interest to disclose.

  • Supervising Editor: James Miner, MD.

Address for correspondence and reprints: Michael J. Ward, MD, MBA; e-mail: mward04@gmail.com.

Abstract

ACADEMIC EMERGENCY MEDICINE 2011; 18:1303–1312 © 2011 by the Society for Academic Emergency Medicine

Abstract

In 2011, Academic Emergency Medicine convened a consensus conference entitled “Interventions to Assure Quality in the Crowded Emergency Department.” This article, a product of the breakout session on “interventions to safeguard efficiency of care,” explores various elements of the research agenda on efficiency and quality in crowded emergency departments (EDs). The authors discuss four areas identified as critical to achieving progress in the research agenda for improving ED efficiency: 1) What measures can be used to understand and improve the efficiency and quality of interventions in the ED? 2) Which factors outside of the ED’s control affect ED efficiency? 3) How do workforce factors affect ED efficiency? 4) How do ED design, patient flow structures, and use of technology affect efficiency? Filling these knowledge gaps is vital to identifying interventions that improve the delivery of emergency care in all EDs.

Ancillary