Salodof MacNeil J. ICU transfer delays may be deadly. Medscape Medical News [serial online]. May 2004.

This article is about a new study that says delays in transferring patients in deteriorating condition to intensive care units can mean reduced chances for survival and for retaining enough function to return home.

Hamby L, Fraser S. Using patient waiting-time data to improve the hospital bed-assignment process. The Joint Commission Journal on Quality and Safety. January 2004;30(1):42-46.

This article describes the uses and benefits of a bed-tracking system at Piedmont Hospital in Atlanta, Georgia, USA.

Rozich JD, Resar RK. Using a unit assessment tool to optimize patient flow and staffing in a community hospital. Journal on Quality Improvement. 2002 Jan;28(1):31-41.

This article discusses how confusion in scheduling, related at least in part to the complex interplay of clinical acuity and highly individualized care, often adversely effects the flow of patients through the hospital. Luther Midelfort recently began to change the process of patient flow to improve access to care, optimize outcomes by enabling timely intervention, and decrease the wasting of resources.

Institute for Healthcare Improvement. IHI Innovation Series white paper. Optimizing Patient Flow: Moving Patients Smoothly Through Acute Care Settings. Boston, Massachusetts: Institute for Healthcare Improvement; 2003.

IHI Innovation Series white paper

Because waits, delays, and cancellations are so common in health care, patients and providers assume that waiting is simply part of the care process. But recent work on assessing the reasons for delays suggests otherwise.

Full text available! Click view white paper below.

United States General Accounting Office. Hospital Emergency Departments: Crowded conditions vary among hospitals and communities. United States General Accounting Office. 2003;1-71.

A United States government report prepared in order to provide national data on issues of emergency department overcrowding.

Full Text Available! Click View Article below.

Harvard School of Public Health. Nurse staffing and patient outcomes in hospitals. Health Resources Services Administration. 2001;1-487.

A study co-sponsored by the Health Resources and Services Administration Division of Nursing, Health Care Financing Administration (HCFA), Agency for Healthcare Research and Quality, and National Institutes of Nursing Research of the National Institutes of Health to gather information about the relationship between nurse staffing in hospitals and its effect on clinical outcomes.

Full Text Available! Click View Article below.

Tarnow-Mordi WO, Hau C, Warden A, Shearer AJ. Hospital mortality in relation to staff workload: A four year study in an adult intesive care unit. The Lancet. 2000;356(9225):185-189.

This study found mortality rates were two times higher when the intensive care unit staff is experiencing a high workload.

Shull MJ, Szalai JP, Schwartz B, Redelmeier DA. Emergency department overcrowding following systematic hospital restructuring: Trends in twenty hospitals over ten years. Academic Emergency Medicine. 2001;8(11):1037-1043.

Investigates the effect of hospital restructuring on emergency department overcrowding.

Shull MJ, Morrison LJ, Vermeulen M, Redelmeier DA. Emergency department overcrowding and ambulance transport delays for patients with chest pain. Canadian Medical Association Journal. 2003;168(3):277-283.

Investigates pre-hospital delays for cardiac patients as the result of emergency department overcrowding.

McManus ML, Long MC, Cooper AB, et al. Variablity in surgical caseload and access to intensive care services. Anesthesiology. 2003;98:1491-1496.

This is the first publication on application of the variability methodology introduced in the GAO Report on "Hospital Emergency Departments: Crowded Conditions Vary among Hospitals and Communities". It provides a quantitative demonstration of the effect of artificial variability on hospital throughput and access to the intensive care unit.