Quantifying Dynamic Flow of Emergency Department (ED) Patient Managements: A Multistate Model Approach
Table 2
Estimated rates of patient movement rates (per person-hour) and the effects of the age group and triage level from the five-state Markov model.
Patient movement
Movement rate
Number of movement in a steady ER
Effect of the triage level
Effect of the age group
Estimate
95% CI
RR
95% CI
RR
95% CI
Triage ⟶ physician
4.224
(4.204–4.247)
—
0.962
0.956–0.967
1.134
1.131–1.139
Physician ⟶ observation room
0.099
(0.098–0.100)
6
0.673
0.666–0.679
1.549
1.539–1.562
Triage (directly) ⟶ departure
0.0005
(0.0003–0.0008)
0
1.481
0.974–1.962
1.174
0.840–1.618
Physician (directly) ⟶ discharge
0.235
(0.233–0.236)
14
1.891
1.881–1.900
0.773
0.769–0.776
Observation room ⟶ discharge
0.011
(0.011–0.012)
1
1.650
1.619–1.677
0.619
0.609–0.628
Physician (directly) ⟶ admission
0.046
(0.045–0.047)
3
0.757
0.745–0.766
0.830
0.821–0.839
Observation room ⟶ admission
0.019
(0.018–0.019)
2
0.842
0.826–0.856
0.910
0.899–0.921
After triage and in a steady ER system with 60 patients in the treatment bed area and 100 patients in the observation, the number of patients for each kind of movement between two states in an hour, rounded to integer. Statistically significant. RR, relative rate. The reciprocal of the patient movement rate is the mean time gap before the next patient movement occurs. An effect of greater than 1 represents an accelerating effect on the corresponding movement.
