A new strategy for emergency department crowding: High-turnover utility bed intervention

I. Hsin Lee, Chung Ting Chen, Yi Tzu Lee, Yueh Shuang Hsu, Chia Ling Lu, Hsien Hao Huang, Teh Fu Hsu, Chorng Kuang How*, David Hung Tsang Yen, Ueng Cheng Yang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background This study applied a new strategy, termed high-turnover utility bed intervention, to offer early admission chances for emergency department (ED) patients and alleviate ED crowding. Methods This before-and-after observational cohort study was conducted at the ED of an urban tertiary hospital. On January 1, 2012, 14 utility beds were prepared exclusively for ED patient use. A strict 48-hour course limit for each patient was formulated to govern these high-turnover beds. The primary outcome measure for this study was ED length of stay. Secondary outcome measures were the number of ED admissions, patients who left without being seen, and revisits within 72 hours of discharge, as well as the outcomes of cardiac arrest management and ambulance diversion hours. Results There were 70,515 adult ED visits enrolled during the preintervention period (January–December 2011), and 69,706 during the postintervention period (July 2012–June 2013). In the postintervention period, this new strategy offered 1401 early admission opportunities. The ambulance diversion hours decreased prominently from 5.4 hours to 1.6 hours per day. A shortening in ED length of stay from 9.7 hours to 8.0 hours was achieved, mainly in cases of nontrauma. More patients (31.2% vs. 29.7%) were admitted to the wards with a lower discharge rate in the postintervention period. Additionally, there was no difference in ED revisit within 72 hours and cardiac arrest management. Conclusion The high-turnover ED utility bed intervention offered improved admission chance and alleviated ED crowding output. ED efficiency improved, with shortened ED length of stay and fewer ambulance diversion hours.

Original languageEnglish
Pages (from-to)297-302
Number of pages6
JournalJournal of the Chinese Medical Association
Issue number5
StatePublished - May 2017


  • ambulance diversion
  • crowding
  • emergency department
  • length of stay
  • turnover rate


Dive into the research topics of 'A new strategy for emergency department crowding: High-turnover utility bed intervention'. Together they form a unique fingerprint.

Cite this