Improving patient flow processes may have better impacts than structural / physical reorganisation of the emergency department.
Many approaches to reduce emergency department crowding require extra space and staff. This study compared the impact of expanding the emergency department versus improving patient flow processes through a rapid assessment unit at hospital. The hospital first undertook physical expansion and then later reorganised patient flow. After emergency department expansion there were negative outcomes including increased length of stay and more patients leaving without being seen. After the rapid assessment unit was set up, patients saw professionals more quickly and had reduced length of stay (average 67 minutes).
Reference: Sayah A, et al. Emergency department expansion versus patient flow improvement: impact on patient experience of care. Journal of Emergency Medicine. 2015.