Skip to main content
OpenTrials
Completed

NCT Number: NCT03185533

Reducing Length of Stay in the Emergency Department

Emergency department (ED) crowding has become an international challenge in the recent decades.

Length of stay (LOS) is a useful marker to monitor ED crowding. Searching for the possible causes and reducing barriers may have the greatest impact on EDLOS.

Therefore, the investigators assembled a multidisciplinary team for improvement of the ED process, to undergo assessments of ED patient flow with the spirit of lean-sigma methodologies. The objectives of this study were to evaluate a Lean-sigma-based initiative to lessen EDLOS.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Length of Stay

Sex eligibility

All sexes

Study type

Observational

About this study

Lean aims to smooth out the workflow and to eliminate wastes. In the ED settings, lean principles can display the process of the ED patient flow. Six sigma, a complementary strategy, has the merit to compensate the potential weakness of Lean through a data-driven process. Currently, a combination of Lean and Six sigma methodologies develops to solve the problems of workflow.

It became clear that concurrent multifaceted interventions were needed to reduce EDLOS. Therefore, the investigators assembled a multidisciplinary quality improvement team for improvement of the ED process, to undergo assessments of ED patient flow with the spirit of lean-sigma methodologies. The objectives of this study were to evaluate a Lean-sigma-based initiative to lessen EDLOS.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • the patients were registered in the ED from Jan, 2015 to Dec, 2015.

Exclusion criteria

  • the patients were excluded because of left without seeing a physician.

Treatment and study plan

Quality improvement (QI) interventions

Behavioral
  • The ED admissions exhibited prolonged length of stay.
  • The Interventions for Reducing Medical Decision Time:
  • The ED director created QI education sessions and reported monthly QI outcomes.
  • The ED nurses reported the current number of ED admission patients twice a day to the director. The director summarized the bed requests to the administrative personnel.
  • The nurses reported the in-scene complicated cases to the ED director. The director would give an assistance in managing these cases.
  • The Interventions for Reducing Boarding Time
  • The ED patients could be admitted before 8 a.m. if the bed was vacant.
  • The ED director initiated an on-line meeting at 8 a.m. and 4 p.m.
  • Monthly QI outcomes were reported in the hospital affairs meeting.

Primary outcomes

  1. length of stay for ED admissions.

    Time frame: 12 months

    Length of stay was defined as the time from patient registration to leaving the ED.

Secondary outcomes

  1. boarding time for ED admissions

    Time frame: 12months

    Boarding time was defined as the time from decision for admission to leaving the ED.

  2. decision time for ED admissions

    Time frame: 12 months

    Decision time was defined as the time from patient registration to decision for disposition.

  3. the percentage of LOS over 24 hours in all ED patients.

    Time frame: 12 months

    The percentage was defined as patients staying at the ED over 24 hours/total ED visits.

Sponsors and collaborators

Lead sponsor

National Taiwan University Hospital Hsin-Chu Branch

Other

Registry information

Official study title

Reducing Length of Stay in the Emergency Department: Analyzing the Factors and Quality Improvement Interventions

Important dates

Study start
2015
Primary completion
2015
Study completion
2015
First posted
Jun 14, 2017
Registry last updated
Jun 14, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.