Impact of Rapid Medical Evaluation on Patient Flow in an Urban Emergency Department.

Abstract

Rapid Medical Evaluation (RME) is a new Emergency Department (ED) process that initiates testing while patients are in the Waiting Room. Primary goal of this study is to assess the effectiveness of RME pathway on the patient flow through the ED.This was a retrospective, single site, cohort study of patients presenting to the ED 12months before (PRE group) and 12months after (POST group) RME implementation. The POST group was divided into those that underwent RME and those managed using standard care pathway (SCP). Data was collected from Electronic Health Record (EHR) database using SQL and consisted of time stamp data for discrete ED patient events. The following metrics were calculated for all ED encounters: Active ED Room Time, Boarding Time, Total ED Room Time, Total ED Time, and Door-to-Provider Time.Patients undergoing RME on average spent 90-min less in ED Treatment Room compared to SCP group and were evaluated by a provider 151min earlier than if they had waited for an available ED Treatment Room.Implementation of RME helped reduce time patients spend in ED Treatment Room, improved patient throughput, and decreased Door-to-Provider time during the busiest times in the ED.