ArticleEmergency medicine journal : EMJ2013
Decreased length of stay after addition of healthcare provider in emergency department triage: a comparison between computer-simulated and real-world interventions.
Article in Emergency medicine journal : EMJ, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Pooled it
- Systems science and childhood obesity: a systematic review and new directions.Journal of obesity · 2013Pooled it
- Key performance indicators in emergency department simulation: a scoping review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Optimizing Emergency Department Operations: A Simulation Framework for Managerial Decision-Making.Journal of nursing management · 2025Article
- Leveraging quality improvement initiatives to support development of decision support tools in healthcare.Health systems (Basingstoke, England) · 2025Article
- Quantifying Dynamic Flow of Emergency Department (ED) Patient Managements: A Multistate Model Approach.Emergency medicine international · 2020Article
- Queueing theoretic analysis of labor and delivery : Understanding management styles and C-section rates.Health care management science · 2019Article
- Simulation-Based Design of ED Operations with Care Streams to Optimize Care Delivery and Reduce Length of Stay in the Emergency Department.Journal of medical systems · 2017Article
- A preliminary study of a novel emergency department nursing triage simulation for research applications.BMC research notes · 2017Article
- Impact of a physician-in-triage process on resident education.The western journal of emergency medicine · 2014Observational
- Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital.The American journal of emergency medicine · 2014Article
- Patient throughput benefits of triage liaison providers are lost in a resource-neutral model: a prospective trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2014Article
- Addressing the variation of post-surgical inpatient census with computer simulation.Pediatric surgery international · 2014Article
- Reducing Pediatric ED Length of Stay by Reducing Diagnostic Testing: A Discrete Event Simulation Model.Pediatric quality & safetyArticle
- Simulation to Predict Effect of Citywide Events on Emergency Department Operations.Pediatric quality & safetyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objective(1) To determine the effects of adding a provider in triage on average length of stay (LOS) and proportion of patients with >6 h LOS. (2) To assess the accuracy of computer simulation in predicting the magnitude of such effects on these metrics.
methodsA group-level quasi-experimental trial comparing the St. Louis Veterans Affairs Medical Center emergency department (1) before intervention, (2) after institution of provider in triage, and discrete event simulation (DES) models of similar (3) 'before' and (4) 'after' conditions. The outcome measures were daily mean LOS and percentage of patients with LOS >6 h.
resultsThe DES-modelled intervention predicted a decrease in the %6-hour LOS from 19.0% to 13.1%, and a drop in the daily mean LOS from 249 to 200 min (p<0.0001). Following (actual) intervention, the number of patients with LOS >6 h decreased from 19.9% to 14.3% (p<0.0001), with the daily mean LOS decreasing from 247 to 210 min (p<0.0001).
conclusionPhysician and mid-level provider coverage at triage significantly reduced emergency department LOS in this setting. DES accurately predicted the magnitude of this effect. These results suggest further work in the generalisability of triage providers and in the utility of DES for predicting quantitative effects of process changes.
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Registered trials
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