Impact of New Bed Assignment Information System on Emergency Department Length of Stay: An Effect Evaluation for Lean Intervention by Using Interrupted Time Series and Propensity Score Matching Analysis

Yun, Chih-Chien; Huang, Sin-Jhih; Kuo, Tsuang; Li, Ying-Chun; Juang, Wang-Chuan

doi:10.3390/ijerph19095364

Open AccessArticle

Impact of New Bed Assignment Information System on Emergency Department Length of Stay: An Effect Evaluation for Lean Intervention by Using Interrupted Time Series and Propensity Score Matching Analysis

by

Chih-Chien Yun

¹,

Sin-Jhih Huang

²,

Tsuang Kuo

³,

Ying-Chun Li

⁴ and

Wang-Chuan Juang

^2,3,4,*

¹

Department of Emergency, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan

²

Quality Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan

³

Department of Business Management, National Sun Yat-sen University, Kaohsiung 804201, Taiwan

⁴

Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung 804201, Taiwan

^*

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2022, 19(9), 5364; https://doi.org/10.3390/ijerph19095364

Submission received: 30 December 2021 / Revised: 8 April 2022 / Accepted: 27 April 2022 / Published: 28 April 2022

(This article belongs to the Section Health Care Sciences & Services)

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Abstract

A long waiting period for available beds in emergency departments (EDs) is the major obstacle to a smooth process flow in ED services. We developed a new bed assignment information system that incorporates current strategies and resources to ease the bottleneck in the service flow. The study’s purpose was to evaluate the effect of the lean intervention plan. We included 54,541 ED patient visits in the preintervention phase and 52,874 ED patient visits in the postintervention phase. Segmented regression analysis (SRA) was used to estimate the level and trend in the preintervention and postintervention phases and changes in the level and trend after the intervention. After the intervention, the weekly length of stay (LOS) for patient visits, admitted patient visits, and nonadmitted patient visits decreased significantly by 0.75, 2.82, and 0.17 h, respectively. The trendline direction for overall patient visits and nonadmitted patient visits significantly changed after the intervention. However, no significant change was noted for admitted patient visits, although the postintervention trend visually differed from the preintervention trend. The concept of lean intervention can be applied to solve various problems encountered in the medical field, and the most common approach, SRA, can be used to evaluate the effect of intervention plans.

Keywords: emergency department crowding; length of stay; lean; interrupted time series; intervention

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MDPI and ACS Style

Yun, C.-C.; Huang, S.-J.; Kuo, T.; Li, Y.-C.; Juang, W.-C. Impact of New Bed Assignment Information System on Emergency Department Length of Stay: An Effect Evaluation for Lean Intervention by Using Interrupted Time Series and Propensity Score Matching Analysis. Int. J. Environ. Res. Public Health 2022, 19, 5364. https://doi.org/10.3390/ijerph19095364

AMA Style

Yun C-C, Huang S-J, Kuo T, Li Y-C, Juang W-C. Impact of New Bed Assignment Information System on Emergency Department Length of Stay: An Effect Evaluation for Lean Intervention by Using Interrupted Time Series and Propensity Score Matching Analysis. International Journal of Environmental Research and Public Health. 2022; 19(9):5364. https://doi.org/10.3390/ijerph19095364

Chicago/Turabian Style

Yun, Chih-Chien, Sin-Jhih Huang, Tsuang Kuo, Ying-Chun Li, and Wang-Chuan Juang. 2022. "Impact of New Bed Assignment Information System on Emergency Department Length of Stay: An Effect Evaluation for Lean Intervention by Using Interrupted Time Series and Propensity Score Matching Analysis" International Journal of Environmental Research and Public Health 19, no. 9: 5364. https://doi.org/10.3390/ijerph19095364

APA Style

Yun, C.-C., Huang, S.-J., Kuo, T., Li, Y.-C., & Juang, W.-C. (2022). Impact of New Bed Assignment Information System on Emergency Department Length of Stay: An Effect Evaluation for Lean Intervention by Using Interrupted Time Series and Propensity Score Matching Analysis. International Journal of Environmental Research and Public Health, 19(9), 5364. https://doi.org/10.3390/ijerph19095364

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Impact of New Bed Assignment Information System on Emergency Department Length of Stay: An Effect Evaluation for Lean Intervention by Using Interrupted Time Series and Propensity Score Matching Analysis

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