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. 2012 May-Jun;19(3):443-7.
doi: 10.1136/amiajnl-2011-000462. Epub 2011 Nov 3.

Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department

Stephanie Spellman Kennebeck  1 , Nathan Timm, Michael K Farrell, S Andrew Spooner
Affiliations

Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department

Stephanie Spellman Kennebeck et al. J Am Med Inform Assoc. 2012 May-Jun.

Abstract

Implementing electronic health records (EHR) in healthcare settings incurs challenges, none more important than maintaining efficiency and safety during rollout. This report quantifies the impact of offloading low-acuity visits to an alternative care site from the emergency department (ED) during EHR implementation. In addition, the report evaluated the effect of EHR implementation on overall patient length of stay (LOS), time to medical provider, and provider productivity during implementation of the EHR. Overall LOS and time to doctor increased during EHR implementation. On average, admitted patients' LOS was 6-20% longer. For discharged patients, LOS was 12-22% longer. Attempts to reduce patient volumes by diverting patients to another clinic were not effective in minimizing delays in care during this EHR implementation. Delays in ED throughput during EHR implementation are real and significant despite additional providers in the ED, and in this setting resolved by 3 months post-implementation.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Timeline of events. H1N1 surge includes greater than 20% above normal volume attributed to flu-like illness, overflow clinic includes all days clinic saw patients, electronic health record rollout includes 14 days that extra staffing was employed, starting with rollout day. EHR, electronic health record.
Figure 2
Figure 2
Average lengths of stay.
See this image and copyright information in PMC

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