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Monday, October 8, 2018  |  10:00 AM - 11:00 AM

Open to Conference Attendees Only

Re-Thinking the ED: Optimizing the ED Efficiency and Patient Flow

Benjamin Easter, MD, MBA
Assistant Professor, Department of Emergency Medicine, University of Colorado School of Medicine
Negin Houshiarian, MArch, PhD
Healthcare Designer and Researcher, HkS Inc.
Debajyoti Pati, PHD, FIIA, LEED AP
Professor, Texas Tech University

As ED crowding has worsened and its effects catalogued, ED leaders have sought process improvements around efficiency while architects have proposed design strategies to achieve the same. Unfortunately, these efforts have largely failed to cross professional boundaries. In this session, we will share the results of research about the interaction between ED design and flow with a goal to optimize split-flow patient care systems. This empirical study is a 2 factor analysis, examining the interaction of 3 flow models with 3 design types to compare operational metrics and patient-centered metrics. We used 21 months of patient data at The University of Colorado ED to create and validate 9 simulation models and extrapolated their performance. Flow split by ESI with 1 waiting area (the most common model used by EDs) was used as the control. Our results will show which model improved operational and patient centered metrics.



1. Evaluate models of care, the interaction of flows and physical design typologies, on ED flow metrics, including length of stay and room turnover.
2. Compare ED models on patient-centered metrics, including door to provider time, left without being seen rate, and number of movements per patient.
3. Assess the best options for an ED with either fixed flow or fixed design, and demonstrate how changes in the other variables improve outcomes.
4. Introduce a multi-disciplinary (medical science, healthcare design, and process engineering) research method to offer a solution for ED efficiency.

SESSION FOCUS AREAS: = Generative Space = NOAH