Reducing Overcrowding in the Emergency Department Using LSS Approach

Overcrowding in Emergency Departments (EDs) is an issue on the agenda due to the inevitable, and sometimes serious, consequences for patients and the medical and nursing staff who work there. The effects due to overcrowding within the ED have repercussions both on patients in terms of increased waiting times, increase in the phenomenon of leaving the ED before completing the clinical process, and on operators. Among the various causes of the phenomenon, we must recognize the aging of the population, the availability of new diagnosis and treatment technologies and a high percentage of inappropriate access due to the lack of local services. The analysis in question, through the study of the data of patients who accessed the ED of the “Santa Maria della Pietà” hospital in Nola, Naples (Italy) in 2019, has the aim of identifying all those variables that influence the efficiency parameter of the performance of the ED process: the Length of Stay (LOS). A statistical analysis of the data is carried out, then through the implementation of a logistic regression model two groups of data are compared based on a threshold value of the ED-LOS set at 480 min. According to the findings, subjects with non-critical illnesses diseases and accessibility in the nighttime hours are the most probable for patients to leave the ED.