Observational studyPloS one2018
Long length of stay at the emergency department is mostly caused by organisational factors outside the influence of the emergency department: A root cause analysis.
Observational study in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 77 citations in OpenAlex.
- Emergency department crowding in the modern era: a systematic review (2018-2025).Clinical and experimental emergency medicine · 2026Pooled it
- Methodological Approaches to Support Process Improvement in Emergency Departments: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Trial
- Where's the way out? Access block, boarding and hospital overcrowding: a narrative review.Internal and emergency medicine · 2026Review
- Observational
- Do older patients with mental health presentations stay in the emergency department longer than younger patients? - A retrospective study.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2026Article
- Comparing Performance Outcomes of Emergency Medicine-Trained vs. Non-Emergency Medicine-Trained Physicians in Emergency Departments.Journal of acute medicine · 2025Article
- Streamlining emergency nursing care post-pandemic: A lean approach for reducing wait times and improving patient and staff satisfaction in the hospital.BMC nursing · 2025Article
- Factors that predict emergency department length of stay in analysis of national data.Clinical and experimental emergency medicine · 2025Article
- Emergency department crowding: An examination of older adults and vulnerability.Nursing ethics · 2025Article
- Degree of Compliance of Hospital Emergency Departments With the Recommended Standards and Their Evolution During the SARS-CoV-2 Pandemic.Journal of nursing management · 2025Observational
- Optimizing Emergency Department Length of Stay and Quality of Care: A Quality Improvement Project.Cureus · 2024Article
- From symptom onset to ED departure: understanding the acute care chain for patients with undifferentiated complaints: a prospective observational study.International journal of emergency medicine · 2024Article
- Improving the emergency services using quality improvement project and Donabedian model in a quaternary teaching hospital in South India.BMJ open quality · 2024Article
- Article
- Acute abdominal pain at referral emergency departments: an analysis of performance of three time-dependent quality indicators.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Article
- Effectiveness of a Mobile App (PIMPmyHospital) in Reducing Therapeutic Turnaround Times in an Emergency Department: Protocol for a Pre- and Posttest Study.JMIR research protocols · 2023Article
- Returns After Discharge From the Emergency Department Observation Unit: Who, What, When, and Why?The western journal of emergency medicine · 2023Article
- Factors affecting the length of stay in the emergency department for critically Ill patients transferred to regional emergency medical center.Nursing open · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency department (ED) crowding is common and associated with increased costs and negative patient outcomes. The aim of this study was to conduct an in-depth analysis to identify the root causes of an ED length of stay (ED-LOS) of more than six hours.
methodsAn observational retrospective record review study was conducted to analyse the causes for ED-LOS of more than six hours during a one-week period in an academic hospital in the Netherlands. Basic administrative data were collected for all visiting patients. A root cause analysis was conducted using the PRISMA-method for patients with an ED-LOS > 6 hours, excluding children and critical care room presentations.
results568 patients visited the ED during the selected week (January 2017). Eighty-four patients (15%) had an ED-LOS > 6 hours and a PRISMA-analysis was performed in 74 (88%) of these patients. 269 root causes were identified, 216 (76%) of which were organisational and 53 (22%) patient or disease related. 207 (94%) of the organisational factors were outside the influence of the ED. Descriptive statistics showed a mean number of 2,5 consultations, 59% hospital admissions or transfers and a mean age of 57 years in the ED-LOS > 6 hours group. For the total group, there was a mean number of 1,9 consultations, 29% hospital admissions or transfers and a mean age of 43 years.
conclusionsThis study showed that the root causes for an increased ED-LOS were mostly organisational and beyond the control of the ED. These results confirm that interventions addressing the complete acute care chain are needed in order to reduce ED-LOS and crowding in ED's.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.