Determinates of Throughput Times in the Emergency Department

This article studies factors that affect throughput times in a level 1 inner city emergency department (ED) in Chicago, USA. Previous research has shown increased throughput times are related to non-urgent patient use of the ED and lack of coordination of auxiliary hospital departments. Knowledge of these factors will allow for an improvement in patient flow and a reduction in wait times. This is a retrospective study of all factors that contribute to throughput times. Data was collected on a monthly basis for a four-year period that included presenting illness, triage level, wait times, time taken for laboratory results, radiology, bed availability, admitted or sent home, Fast Track availability, age, gender and race. The results show that factors affecting throughput are influenced by numerous determinants often beyond the ED itself. The two most influential are: the numbers of presenting illnesses that require in-patient beds, and the ability of the hospital's auxiliary departments, such as the lab, to meet the needs of the ED in a timely fashion. Based on these findings, the way to reduce throughput times is to focus on auxiliary hospital systems, such as laboratory, psychiatry and medicine, which support the ED.