Hurry up, it´s quiet in the emergency department

Ewoud ter Avest, B.T. Onnes, T. van der Vaart, Martin Land

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
22 Downloads (Pure)


Introduction: Emergency department (ED) crowding is
a contemporary problem. Solutions are multiple, but
often involve a lengthy implementation process and/or
substantial funding. Therefore, it is important that in the
meanwhile, we aim to identify simple strategies, focussing
on optimising efficiency of the available resources, which
can be adopted in the ED here and now.
Methods: We made a careful analysis of inflow, throughput
and outflow data of all 24,823 patients visiting the ED of a
large teaching hospital in the year 2015, and looked in more
detail at the 10 days with the longest average throughput times.
Results: The average throughput time during the study
period was 130 minutes. The time between inflow and
outflow peaks was well beyond the average daily ED
throughput time, indicating that the ‘midday surge’
in patient arrivals could not be handled adequately by
the ED system. For the 10 days with the longest average
throughput times, we found a very distinctive pattern, with
a backlog of patients building up in the morning hours
when maximum bed capacity had not yet been reached.
This backlog had consequences during a significant part
of the day.
Conclusion: Improved timing of internal efforts in the ED
based on careful analysis of ED performance data should be
an integral part of a system approach to prevent ED crowding.
Original languageEnglish
Pages (from-to)32-35
Number of pages4
JournalThe Netherlands Journal of Medicine
Issue number1
Publication statusPublished - Jan-2018


  • Crowding, emergency department, throughput time
  • CARE

Cite this