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The June 2007 program is now full.  If you would like to be placed on an interest list for future offerings, please contact Janice Gagnon at jgagnon@ihi.org.

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Excessive waits and delays in emergency room care continue to make regular headlines in the national media. A recent Boston Globe article said that emergency department (ED) overcrowding has prompted many hospitals to spend “millions of dollars to expand their emergency rooms as a possible solution.”

But attempts to improve patient flow that focus only on the ED miss the larger picture: effective patient flow is a property of the entire system and can only be optimized at the system level. For example, EDs often divert patients because hospitals lack the space to move patients forward. Simply increasing capacity in the ED will not solve flow problems.

Poor patient flow affects all clinical areas. Quality of care is affected when patients are placed in holding patterns, “boarded” in the ED or PACU, managed “off service,” or subject to delayed medical or surgical admissions. Patient flow is a system-wide problem, and must be solved at the system level.