America's Hospitals: In Danger or Bouncing Back?

Slide Presentation by James Adams, M.D.

On November 20, 2002, James Adams, M.D., made a presentation in a Web-assisted teleconference at Event 2, which was entitled "Emergency Department Overcrowding and Ambulance Diversion."

This is the text version of Dr. Adams's slide presentation. Select to access the PowerPoint® slides (183 KB).

Emergency Department Overcrowding and Ambulance Diversion

Jim Adams, M.D.
Professor and Chief
Division of Emergency Medicine
Northwestern University/Northwestern Memorial Hospital

Slide 1

This slide contains an example of a line graph that charts the numbers of patients registered, treated, and admitted to Northwestern Memorial Hospital over a 2 week period. Such a record of numbers can be used to help predict the number of patients admitted through the Emergency Department (ED).

Slide 2

We can predict problems tomorrow by projecting, 24 hours in advance:

• Anticipated ED volume.
• Surgical volume.
• Anticipated discharges.
• Transfers/direct admissions.
• Current hospital volume.

Slide 3

Why would we want to predict problems?

• If we can predict problems that will occur tomorrow, we can respond today.
• If we fail to adequately respond, at least we can:
  • Know that we are optimally managing the system.
  • Figure out ways to manage better.
  • Know that there is simply no capacity!

Slide 4

Once we predict a problem, then what?

• Notify medical staff.
  • What do they need?
• Notify managers and key leaders.
  • What do they need?
• Prioritize work to be done:
  • Labs, radiology.
  • Placement, rides home.

Slide 5

How can we begin this process?

• The hospital system must work together as a whole.
• The demands of the ED, including bottlenecks, must be monitored.
  • 5 level, ESI Triage.
  • Real time process controls.
    • Information tools.

Slide 6

• If we monitor the hospital 24 hours in advance of problems, we also must monitor the ED on a real-time basis in order to identify unanticipated problems, bottlenecks, and surges.

Slide 7

Slide contains a picture of a screen showing a real-time monitoring system report. It shows what is being monitored, the status of that situation, and brief messages regarding that situation.

Current as of June 2003

Internet Citation:

Emergency Department Overcrowding and Ambulance Diversion. Slide Presentation by James Adams, at Web-Assisted Teleconference, "America's Hospitals: In Danger or Bouncing Back?" Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/hospital/adamstxt.htm

Return to Teleconference
State & Local Policymakers
AHRQ Home Page