Impact of New Bed Assignment Information System on Emergency Department Length of Stay: An Effect Evaluation for Lean Intervention by Using Interrupted Time Series and Propensity Score Matching Analysis

Abstract

A long waiting period for available beds in emergency departments (EDs) is the major obstacle to a smooth process flow in ED services. We developed a new bed assignment information system that incorporates current strategies and resources to ease the bottleneck in the service flow. The study’s purpose was to evaluate the effect of the lean intervention plan. We included 54,541 ED patient visits in the preintervention phase and 52,874 ED patient visits in the postintervention phase. Segmented regression analysis (SRA) was used to estimate the level and trend in the preintervention and postintervention phases and changes in the level and trend after the intervention. After the intervention, the weekly length of stay (LOS) for patient visits, admitted patient visits, and nonadmitted patient visits decreased significantly by 0.75, 2.82, and 0.17 h, respectively. The trendline direction for overall patient visits and nonadmitted patient visits significantly changed after the intervention. However, no significant change was noted for admitted patient visits, although the postintervention trend visually differed from the preintervention trend. The concept of lean intervention can be applied to solve various problems encountered in the medical field, and the most common approach, SRA, can be used to evaluate the effect of intervention plans.