J Clin Outcomes Manage
Surge: an organizational response to emergency department overcrowding
Moseley MG, Dickerson CL, Kasey J, Key CB, Moore T, Vagarali A, Rund D
Abstract Objective: Emergency department (ED) overcrowding is a national crisis that has many root causes both internal and external to the ED. ED overcrowding can harm patients, impair the patient care experience, and lead to negative operational and financial performance. This article describes an initiative undertaken to respond to ED overcrowding through the development of a comprehensive organizational surge plan that took place at our institution from 2008 to 2009. Methods: The NEDOCS model was selected as an objective measure of ED overcrowding. A multidisciplinary leadership team worked together to create a comprehensive surge plan linked to the NEDOCS. This plan was scalable in terms of increased resource allocation to the ED based on the NEDOCS in order to alleviate crowded conditions. The surge plan was widely disseminated and made an organizational priority with the help of senior leadership. Results: There was a demonstrable improvement in ED operational metrics. Despite significant volume growth during this period, the ED was able to improve throughput times, decrease the number of patients that leave without being seen, and improve patient perception of their ED experience. Conclusion: Through a collaborative, multidisciplinary effort, the Ohio State University Medical Center was able to implement a scalable institution-wide surge protocol linked to the NEDOCS to address ED overcrowding.
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