Table 8.
Outcomes of patient flow improvement solutions
| Main category [31] | Category | Resource No | QAIMS |
|---|---|---|---|
| Proportion-related outcomes | Reduction of ED-LOS/Hospital LOS | [7, 15, 27, 31, 34, 35, 39, 55, 60–64, 66, 68, 69, 71–74, 76–79] | QAIM3 |
| Reduction of Patients left without being seen (LWBS)/Did not wait (DNW) | [15, 27, 34, 35, 60, 64, 66, 68, 69, 72, 73] | QAIM1 | |
| Reduction of patients leaving against medical advice (LAMA) | [68, 72] | QAIM1 | |
| Access block reduction | [13, 15] | QAIM1, QAIM3 | |
| Meeting NEAT targets | [15, 73] | QAIM1, QAIM4 | |
| Manageable ED occupancy level | [39, 66, 74] | QAIM3 | |
| Decrease in Turnover Time (TOT) | [70] | QAIM3 | |
| Decrease in Turnaround Time (TAT) | [70] | QAIM3 | |
| Decrease in hospitalisations | [27, 74] | QAIM3 | |
| Decrease in admission rates | [33, 59, 65, 67, 71, 74] | QAIM3 | |
| Decrease in weekend ED attendances | [15] | QAIM2 | |
| Decrease in ED visits (ambulance admissions & self-referrals) | [15, 36, 68–71, 74, 76, 80] | QAIM3 | |
| Reduction In the number of Non-Urgent/Semi-Urgent/frequent users | [36, 73, 74] | QAIM2 | |
| Improvement of Discharge Rates | [34, 74] | QAIM3 | |
| Improvement of on-time starts (OTS) | [79] | QAIM3 | |
| Decrease in Readmission/Revisit Rates/Relapse | [34, 39, 61, 65–67, 71, 74, 79, 80] | QAIM3 | |
| Decrease in waiting time | [7, 39, 66, 73, 74, 76] | QAIM3 | |
| Reduction in ED transfer rate | [65, 73] | QAIM3 | |
| Decrease in Triage to ED Room/Bed Placement Time | [7, 66, 68, 76] | QAIM3 | |
| Decrease in door to physician time/time to Physician Initial Assessment | [7, 60, 62, 68, 69, 72, 76, 78] | QAIM3 | |
| Decrease in time to initiation of diagnostic testing | [72, 74] | QAIM3 | |
| Decrease in consult response time | [78] | QAIM3 | |
| Decrease in consultation to decision time | [27, 31, 66, 78] | QAIM1, QAIM1 | |
| Proportion of patients consulted | [78] | QAIM4 | |
| Decrease in physician to disposition decision time/ED workup time | [7, 69] | QAIM3 | |
| Reduced patient lead-time from registration to discharge | [73, 77, 79] | QAIM3 | |
| Decrease in Time-to-Treatment | [7, 15, 33, 61, 66, 72] | QAIM3 | |
| Decrease in ED boarding hours or time or count | [15, 34, 60, 66, 79] | QAIM3 | |
| Increase in patients transferred to inpatient bed | [15] | QAIM1, QAIM4 | |
| Number of patients diverted to primary care | [69, 70] | QAIM3 | |
| Cost-related outcomes | Lower costs | [60, 61, 64, 65, 68–74, 78, 79] | QAIM3 |
| Resource utilisation | [74] | QAIM3 | |
| Process related outcomes | Reducing overcrowding | [13, 27, 39, 73, 76] | QAIM1 |
| Enhanced throughput efficiency | [34] | QAIM3 | |
| Streamlined door-to-physician process | [35] | QAIM3 | |
| Enhanced referrals to community services | [59, 74] | QAIM2 | |
| Parental hospital visit satisfaction – | [57] | QAIM2 | |
| Reduction in hours of ambulance bypass/diversion | [15, 39, 66] | QAIM3 | |
| Enhanced patient access to ED | [34] | QAIM3 | |
| Decrease in the Emergency Department Work Index (EDWIN) score | [39] | QAIM3 | |
| Reducing ED utilisation | [36, 69, 73] | QAIM3 | |
| Patient or provider related outcomes | Improve the patient experience | [15, 32, 35, 39, 55, 57, 59, 63, 67–69, 72, 73, 76, 77, 79, 81] | QAIM1 |
| Improved clinical experiences | [29, 76, 79] | QAIM4 | |
| Decrease in serious adverse event (e.g., mortality, ICU admission) | [15, 35, 39, 70–72] | QAIM2 | |
| Enhanced patient safety | [59, 69] | QAIM1 | |
| Improved health-related quality of care | [59] | QAIM1 | |
| Improvement in Patient's quality of life | [70] | QAIM1 | |
| Adherence to treatment | [57] | QAIM1, QAIM2 | |
| Decrease in potentially avoidable diagnostic tests and treatments | [72] | QAIM3 | |
| Reduction in medication errors | [39, 57, 74, 77] | QAIM1, QAIM4 | |
| Symptom relief | [33] | QAIM1 | |
| Reduced ED staff stress level | [15, 66] | QAIM4 | |
| Satisfaction of staff | [15, 59, 63, 72, 79] | QAIM4 |
AIMs: QAIM1: Improve the patient experience of care
QAIM2: Improved population health
QAIM3: Reduced cost and improved efficiency
QAIM4: Enhance the work-life balance and satisfaction of healthcare providers