Factors associated with length of stay in the Emergency Department: A narrative review

ABSTRACT

@#BACKGROUND: Increasing demand and complex procedures may associate with the length of stay (LOS) in the Emergency Department (ED). Prolonged LOS may decrease the quality of ED care and increase patient harm. Therefore, it is pivotal to analyze factors that may contribute to ED LOS. OBJECTIVE: This review aimed to identify and discuss factors that contribute to the Emergency Department length of stay (ED LOS) to improve the quality of care. METHODS: Relevant healthcare databases including PubMed and CINAHL were searched using the combinations of search terms length of stay, length of visit, emergency department, emergency room, and patient flow. Inclusion criteria included publications between 2007-2017. RESULTS: A total of 24 relevant papers was selected. The literature indicates that three main factors are associated with ED LOS input (older patients and acuity level), throughput (diagnostic tests and or radiology, specialist consultation), and output (need for admission and boarding time). CONCLUSION: Input, throughput, and output factors are contributed to ED LOS. Further review is necessary to determine organizational factors that may contribute ED LOS including the number of health staff, staff workload, flow studies, and health system.