Who Is Next: Patient Prioritization Under Emergency Department Blocking

Abstract

In “Who Is Next: Patient Prioritization Under Emergency Department Blocking,” Li, Sun, and Hong study how physicians and nurses choose the next patient for treatment in hospital emergency departments (EDs). Using data from a tertiary hospital in Alberta, Canada, they conduct an empirical investigation and find that both clinical factors and resource constraints are considered in patient-prioritization decisions. In particular, discharged patients are prioritized when ED beds are increasingly occupied by boarding patients so as to avoid further blocking the ED. A stylized model is developed to explain the rationale behind the prioritization behavior. Using a simulation study, they show such behavior can improve ED operations by reducing the average patient waiting time and length of stay without adding extra capacity, which results in significant cost savings for hospitals.