Improving Emergency Department Throughput by Reducing Time to Specialist Consults

Emergency Departments are continually challenged by increasing patient volumes and limited resources as they attempt to treat patients with high quality care in a timely manner. Reconciling these demands can lead to compromise in quality of care, expedition of care, or—often—both. For this reason, Emergency Department patient flow, or throughput, has become a target for quality improvement initiatives. Few, if any, Emergency Departments are immune to the overcrowding that frequently leads to bed holds and extended lengths of stay in the Emergency Department prior to discharge home or to the inpatient setting and subsequent provider and most importantly patient frustration. Though many factors contribute to long stays in the Emergency Department, relatively little attention in the literature is paid to the role of specialist consultations in throughput. This project aims to examine the impact of consultations to specialists by Emergency Department providers on throughput by comparing consults placed to specialist services with a single on-call phone number versus those specialist services without a single on-call phone number using time to admission as a surrogate measure.