Developing Emergency Room Key
Performance Indicators: What to Measure
Mohamed KHALIFA
a,1
and Ibrahim ZABANI
a
a
King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
Abstract. Emergency Room (ER) performance has been a timely topic for both
healthcare practitioners and researchers. King Faisal Specialist Hospital and
Research Center, Saudi Arabia worked on developing a comprehensive set of KPIs
to monitor, evaluate and improve the performance of the ER. A combined
approach using quantitative and qualitative methods was used to collect and
analyze the data. 34 KPIs were developed and sorted into the three components of
the ER patient flow model; input, throughput and output. Input indicators included
number and acuity of ER patients, patients leaving without being seen and revisit
rates. Throughput indicators included number of active ER beds, ratio of ER
patients to ER staff and the length of stay including waiting time and treatment
time. The turnaround time of supportive services, such as lab, radiology and
medications, were also included. Output indicators include boarding time and
available hospital beds, ICU beds and patients waiting for admission.
Keywords. Emergency Room, Performance Indicators, Improvement, Hospitals.
Introduction
Emergency room (ER) crowding and inefficient performance has become a major
barrier to receiving timely emergency care. Patients who visit ER often face long
waiting times to be treated and might wait longer to be admitted [1]. One conceptual
model partitions ER crowding into three interdependent components: input, throughput,
and output [2]. Input factors reflect sources of patient inflow, throughput factors reflect
bottlenecks and slow processes within the ER and output factors reflect bottlenecks in
other parts of the health care system, such as availability of hospital inpatient beds for
admission [3].A thorough understanding of quality improvement principles and
benchmarking is now necessary for providing patient centered care, improving
customer satisfaction, and evaluating services performance. Emergency professionals
now are asked to provide safe, timely, efficient, and cost-effective care. There is still a
gap in developing and utilizing indicators to measure and control ER performance [4].
Some healthcare managers have the experience and skills of introducing new strategies
and innovating new operating processes to achieve breakthrough performance, but they
continue to use the same old or nonspecific indicators they have been used for years [5].
It is very essential to ask what to measure exactly and why should we measure it; so as
to develop indicators that reflect the actual performance of healthcare organizations [6].
1
Corresponding Author. Consultant, Medical Informatics, Email: dr.m.khalifa@gmail.com.
and Why Should We Measure It?
Unifying the Applications and Foundations of Biomedical and Health Informatics
J. Mantas et al. (Eds.)
IOS Press, 2016
© 2016 The authors and IOS Press. All rights reserved.
doi:10.3233/978-1-61499-664-4-179
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