ArticleJournal of the American College of Emergency Physicians open2026
"The 4D Approach"-An Effective Strategy to Improve Emergency Department Boarding and Operational Outcomes.
Article in Journal of the American College of Emergency Physicians open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Emergency Department (ED) boarding is a nationwide issue that has detrimental effects on morbidity and mortality of patients in the ED. Literature suggests that boarding in the ED is directly correlated with left without being seen rates. To address these challenges at our institution, we implemented the "4D Approach": a homegrown change management methodology designed to drive systemic transformation. The "4D Approach" (Desire, Data, Direction, Dedication) involves building desire for change, organizing data to empower decision making, choosing a direction for hospital-wide alignment of goals, and nurturing dedication to the ever-evolving process. We found this approach to have an impact in reducing left without being seen rates and ED boarding despite increasing daily patient arrivals and admissions during the study period at a single tertiary care academic medical center.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.