Effectiveness of Emergency Medicine Wards in reducing length of stay and overcrowding in emergency departments.

OBJECTIVE This study aims to evaluate the effectiveness of an Emergency Medicine Ward (EMW) in reducing the length of stay (LOS) in the emergency department, length of hospitalization, emergency medical admission rate, and the hospital bed occupancy rate. METHODS This study is a cross-sectional, observational study with a retrospective, quantitative record review conducted at the EMW of a regional acute hospital in Hong Kong from January 2009 to June 2009. RESULTS During the study, a retrospective audit was conducted on 1834 patient records. The five main groups of patients admitted into EMW suffered from cardiac disease (26.5%), pneumonia (19.6%), dizziness (16.2%), Chronic Obstructive Pulmonary Disease (12.3%), and gastroenteritis (7.9%). The mean LOS in the EMW was 1.27 days (SD=0.59). The average emergency medical admission rate within the six-month period was significantly reduced relative to that before the EMW became operational (January 2008 to June 2008). Clinically, the medical in-patient bed occupancy was significantly reduced by 6.2%. The average LOS during in-patient hospitalization after the EMW was established decreased to 4.13 days from the previous length of 5.16 days. CONCLUSIONS EMWs effectively reduce both the LOS during in-patient hospitalization and the avoidable medical admission rate.