Reducing delays is critical to improving all aspects of care in emergency departments. Unnecessary delays can contribute to poor medical outcomes, frustrated and unhappy patients, increased cost from waste and rework, increased harm, and a lower quality of work life for staff. Many hospitals are also finding that improvements in the emergency department are essential in meeting the Centers for Medicare and Medicaid Services and other regulatory requirements for specific clinical conditions, especially acute myocardial infarction and community-acquired pneumonia.

In April 2006, IHI's IMPACT network launched the Operational and Clinical Improvement in the Emergency Department Learning and Innovation Community. As a result of the work in the Improving Flow Through Acute Care Settings Learning and Innovation Community, many organizations identified the need to focus on the microsystem of the emergency department (ED) to target specific improvements within patient care.

The Institute of Medicine (IOM), in its June 2006 report titled “Hospital-Based Emergency Care: At the Breaking Point,” explores the reasons for this shortfall.

Specifically the work of IHI's ED Learning and Innovation Community focuses on:

• Improving patient flow in the emergency department to reduce operational cycle time
• Reducing clinical cycle time and ensuring the reliable application of appropriate care
• Increasing safety
• Improving patient satisfaction
• Improving teamwork and staff satisfaction
• Improving cost outcomes

Teams participating in the ED Community are testing and implementing changes to reduce operational cycle times and improve patient flow within the emergency department.