Improving patient flow through axiomatic design of hospital emergency departments

In response to crowding in hospital emergency departments, efforts have been made to increase patient flow through fast tracks (FT). However FTs are often underutilized. We find that this is mainly caused by the current practice of assigning patients to FT based only on the emergency severity index. This usage results in a coupling between prioritizing of patients and encouraging fast patient flow. By introducing a new index for patient flow, we could uncouple this design problem and significantly decrease the overall patient waiting time (∼50%) compared to that of the existing use of FT.