Decreasing Emergency Department Dwell Time

Bellevue Hospital Medical Center (Bellevue) aims to reduce its median 4.5 hours Emergency Department (ED) dwell time. Addressing the ED dwell time has a major impact on patient outcomes because the longer patients wait for a bed to open up at an inpatient unit, the longer necessary care is delayed. Bellevue engaged a Capstone team to develop a process map detailing the departments and individuals involved in moving patients from the ED to an inpatient unit with cycle time estimates showing how much time it takes to move a patient from the ED to the appropriate floor. Through interviews and observation sessions, the team was able to document the patient flow of the admitting, nursing, and environmental health departments, which, upon review, enabled the team to identify sources of delay. Additionally, the team produced a literature review and final report that included practical solutions, potential barriers, and recommendations for alternative solutions.