Because content in this area is still being developed, it is posted in "document" form — and these documents will be updated as the innovation work progresses.

Hospitals are increasingly challenged to reduce waits and delays in moving patients into and out of inpatient beds. The “competition” for inpatient beds from the emergency department, surgery, direct admissions, etc., creates waits and delays that negatively affect patient safety, and patient and staff satisfaction. Flow is a property of the entire system and can only be optimized at the system level.

IHI's Learning and Innovation Community on Operational and Clinical Improvement in the Emergency Department is focused on improving operations, service, and clinical outcomes in the emergency department. To achieve improved results across multiple dimensions in the Emergency Department it is necessary but not sufficient to improve patient flow within the department. Additional areas requiring attention include the reliable application of appropriate clinical care, safety, patient and staff satisfaction, and financial outcomes.

Those organizations that are chronically faced with holding a large number of patients (> 15 percent) in the emergency department waiting for admission need to initially focus on improving patient flow throughout the hospital to free up inpatient beds.

As IHI learns more with organizations participating in this Community, we will post the newest thinking about improving flow and emergency department care to this Emerging Content section. The ideas in this section are promising but are still being tested and refined.