Shortening emergency department length of stay: Fast track, short-stay unit and acute medical unit

Abstract

Emergency department (ED) length of stay (EDLOS) refers to the waiting time experienced by patients at various stages of the ED. It serves as an indicator of ED overcrowding. Prolonged EDLOS can lead to delays in assessment and care, negatively impacting patient satisfaction, and is associated with a poor prognosis. ED overcrowding may result in higher rates of medical errors, adverse events, and mortality. The crude mortality rate for patients with EDLOS <6 h was significantly lower than for those with EDLOS of 12–24 h and > 24 h. Multiple factors influence EDLOS before admission, including limited medical resources and a high volume of non-emergency cases. Hospitals should develop personalized strategies to reduce EDLOS by analyzing patient volumes and resource demands. In this narrative review, measures involving alternatives to ward admission from the ED such as an emergency fast track (FT), an emergency short-stay ward (ESSW)/emergency short-stay unit (ESSU), and an acute medical unit (AMU)/acute medical admissions unit (AMAU), are summarized, aiming to serve as a reference for shortening EDLOS, improving emergency care efficiency, and optimizing service quality.