How does Imaging Impact Patient Flow in Emergency Departments?

TL;DR

This study uses a simulation model to analyze how imaging delays and bundling affect patient length of stay in emergency departments, highlighting potential strategies to reduce overcrowding.

Contribution

It introduces a discrete event simulation approach to quantify the impact of imaging processes on ED patient flow, which is a novel application in this context.

Findings

Reducing imaging delays significantly decreases patient ED time.

Bundling 10% of imaging orders can lead to notable improvements.

Simulation results support targeted process improvements for ED efficiency.

Abstract

Emergency Department (ED) overcrowding continues to be a public health issue as well as a patient safety issue. The underlying factors leading to ED crowding are numerous, varied, and complex. Although lack of in-hospital beds is frequently attributed as the primary reason for crowding, ED's dependencies on other ancillary resources, including imaging, consults, and labs, also contribute to crowding. Using retrospective data associated with imaging, including delays, processing time, and the number of image orders, from a large tier 1 trauma center, we developed a discrete event simulation model to identify the impact of the imaging delays and bundling image orders on patient time in the ED. Results from sensitivity analysis show that reducing the delays associated with imaging and bundling as few as 10% of imaging orders for certain patients can significantly (p-value < 0.05) reduce the time a patient spends in the ED.