OPTIMIZING LENGTH OF STAY (LOS) OF PATIENTS IN EMERGENCY YELLOW ZONE

Dr Abinash Kumar
Department of Emergency

Introduction Cause Effect Analysis Action plan ANALYSI S

The length of stay (LOS) of emergency • Doctors identified for data • Awareness of doctors.
patients represents an important collection • Analyse the Turnaround
performance parameter. • Register modified as per time of reports
need • Bed availability
Analysis of fixed and influenceable
• Data discussed in • Consultation and decision
determinants of LOS can help in
departmental MRM making
optimizing LOS in Emergency
Acceptable LOS in Emergency is upto 6 hour s • Installation of POC testing
machines Revised Action Plan
Problem statement
• Reassessment by doctors
reinforced in yellow zone • Hourly reassessment of
Overcrowding is one of the most
patients
common problems observed in EDs LOS > 6 hrs
New Target Set • Feedback mechanism to
and is mainly caused by an 39
37 35 38 doctors
excessively long LOS within the ED, 31
26 • To analyze LOS more than 4 hrs • Hourly vital charting
leading to a disruption of all 25
25 21 25

in Emergency and has been set

processes and a dramatic increase in 14
19

10 since month of July ‘23 W ay Forward

risks of emergency treatment
• Yellow zone of ED should
LOS > 4 hrs

May-23
Sep-22
Jul-22

Feb-23

Mar-23
Jun-22

Jun-23
Jan-23

Apr-23
Dec-22
Oct-22

Nov-22

be at par with
Aug-22
R oot Cause Analysis
157
142 intermediary care unit of
1.P atient factors (demographic and 124 101
92 97 the hospital and hence
health - related factors) :Geriatric
Average LOS Preintervention needs intensive
patient, absence of patient’s monitoring and adequate
5 4.52 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23
relatives, co morbidities, finances 4.5 4.1
4.3 staffing
4.05 4.01
3.9
4 3.54
3.8 Average LOS
3.5 3.21
3.41 3.4
3.25 3.35 • Repeated reasssement of
2. O rganizational factors :Specialist Post intervention
3 patients to be enforced
Consultations, delay in reports 2.5
2 • Staff to be adequately
1.5 trained to meet the
3. S tructural factors (emergency care 1
requirement
levels):Adequate manpower, distant 0.5
0
diagnositics (CT),shift change
23

3
22
2

22

23

3
22
22

2
22

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