November 22, 2011, Updated September 11, 2012

Controlling patient flow could be the answer to halting jam-packed ER departments. According to researchers in a new joint study by Ben-Gurion University of the Negev, the Israeli Ministry of Health and Hebrew University of Jerusalem, monitoring the patient flow keeps emergency areas available to those really in need.

The latest study followed patient flow at three urban hospitals in the region that was subjected to 80 missiles over a month long period.

The Ministry of Health ordered emergency medical services, doctors and other official agencies to send casualties with severe conflict-related injuries to the Trauma level 1 hospital and divert others with mild injuries or non-conflict related conditions, such as illnesses or birth, to the other two hospitals.

A statistical analysis of the patient flow over the relevant period revealed that there was a significant redirection of cases to the hospitals after the ministry’s announcement.

“Two important factors contributed to the ability of the health authorities to direct the patient flow: (1) the ongoing monitoring and interventions which were made by the [Ministry of Health], and (2) a centralized EMS system. This situation may not be common in all countries; however, the process by which the decisions with regard to patient flow were taken and implemented could be applicable to other types of health care systems,” the authors wrote.

Taking into account that the vast majority of ER patients are walk-ins and are not brought in by ambulances, Dr. Bruria Adini, a member of the Department of Emergency Medicine at the Faculty of Health Sciences at Ben-Gurion University, said that even greater flow control could have been achieved if the Ministry of Health had made the public aware of the hospitals’ designations.

“Effective utilization of scarce resources is a crucial component of emergency management and can directly influence on the ability of hospitals to treat casualties and save lives. Control of patient flow is an important facilitator towards achieving this goal,” she says.

The study was published in the November issue of Health Policy and Planning, Oxford University Press.

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