A quality improvement initiative led by Osler’s Emergency Program leadership and Organizational Performance teams, with Faisal Khan, Etobicoke General Hospital Emergency Department (ED) Manager, as lead author, was recently published in Healthcare Management Forum. The study, Implementation of the Admission Transfer Unit to reduce Emergency Department boarding, presents a new approach to managing patients with complex needs more effectively. The project introduced Admission Transfer Units (ATUs) as a strategic solution to improve patient flow and reduce delays.
The initiative repurposed the Medical Assessment Unit to serve complex, high-risk patients who often face prolonged wait times for inpatient beds. By utilizing an objective selection tool, the ATUs prioritize patients most at risk for adverse events, such as older adults requiring isolation or those at risk of delirium. This approach not only reduces wait times for these vulnerable patients but also enhances their care by transitioning them from the ED to a more appropriate environment. As a result, the time-to-inpatient-bed was reduced by 13 hours, easing ED pressures and improving patient outcomes.
This initiative highlights how organizational collaboration, data-driven strategies and targeted interventions can profoundly impact both patient outcomes and hospital efficiency by addressing the needs of high-risk patients, improving patient transfers, and alleviating systemic pressures without significant capital investment.