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EMERGENCY DEPARTMENTS: Vertical patient flow model

TAKEAWAY: Hospitals are moving toward treatment of some emergency department patients sitting up (treated vertically) instead of having all patients lie down on a bed or stretcher.

Some hospitals with busy emergency departments are employing new models of care delivery to try to expedite care, including assessing and treating patients who are less seriously ill in chairs or recliners instead of immediately assigning every patient to a bed or stretcher.  Grady Health System (Atlanta, GA), with more than 125,000 ED visits per year, has found that half of ED patients can be treated vertically.  Grady also has a walk-in clinic on campus, which helps with the demand by low-acuity patients, but the clinic is not open 24/7.  Lehigh Valley Hospital-Muhlenberg (Bethlehem, PA) has developed an internal disposition area using the vertical patient flow model.  Because there are no beds in this area, the hospital can treat more ED patients per square foot.

This is not a brand new concept.  A survey taken five years ago found that vertical patient flow has been implemented, or was in process of being implemented, at about 70 percent of 103 academic emergency centers which replied to the survey.  The majority also responded that they have fast track units.


[About GRADY]  Fellows, J. (2015, May). Simple changes for ED results. HealthLeaders, 18(4), 37-40. Retrieved from http://www.healthleadersmagazine-digital.com/healthleadersmagazine/may_2015?folio=37#pg39 

[About the SURVEY] Liu, S.W., Hamedani, A.G., and others. (2013). Established and novel initiatives to reduce crowding in emergency departments. Western Journal of Emergency Medicine, 14(2), 85-89.   http://www.medscape.com/viewarticle/808373

[About LEHIGH VALLEY]  Wheary, J.F. (2014, Dec. 23). Best of 2014: Rethinking the emergency department.  Healthcare Design, Retrieved from http://www.healthcaredesignmagazine.com/print/article/rethinking-emergency-department

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

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