LITERATURE REVIEW ON EVALUATING ER PROCESSES TO IMPROVE PATIENT THROUGHPUT

Scope and Significance of the problem An increasing number of patients have been visiting the ER to address their medical needs. According to Hing and Bhuiya (2012), the number of visits has increased from 102.8 million visits in 1999 to 136.1 million visits in 2009 and the average wait time has also increased from 46.5 minutes to 58.1 minutes (Hing & Bhuiya, 2012). An increase in wait times is associated with boarding patients, ambulance diversion, and patients presenting with non￾emergent medical needs (Hing & Bhuiya, 2012). The increased rate of ER visits has resulted in overcrowding (Carpenter, 2001; Hurwitz et al., 2014; Khangura, Flodgren, Perera, Rowe & Shepperd, 2012; Morgan, 2007; Scrofine & Fitzsimons, 2014; Sinreich & Marmor, 2005;