Early Team Assessment in the Emergency Department Leads to Improved Patient Care and Patient Satisfaction

Traditional emergency department care models where patients wait to receive care in a room or bed lead to delays in patient assessment and throughput. We aimed to determine if an early team assessment model is associated with improved patient throughput and quality measures.

This is a retrospective "before-after” observational study of emergency department patients in a high volume urban academic hospital. The control period was June 2024 to May 2025 with an intervention period of June 2025 to December 2025. Pre-intervention patients were seen by a triage nurse who initiated care with nursing protocols and patients awaited an available bed to be seen by a provider (physician or advance practice provider). Post intervention patients were seen in triage by a provider who completed a full assessment and placed orders, then followed the patient throughout the visit. Outcomes included: times to provider, left without being seen rates, emergency department length of stay and likelihood to recommend. Data was abstracted from electronic utilization reports. Adjusted outcomes were computed using interrupted time series generalized linear models.

Over the study period there were 147,127 patients (93,477 pre intervention, 53,650 post intervention). Groups were similar in terms of age, gender, and acuity. Prior to implementation, average time to provider was 122 minutes and left without being seen rates were 7.8% on average. After implementation, time to provider significantly decreased to 40.9 minutes (adj. mean ratio=.41, 95%CI:.39-.43) and left without being seen rates significantly decreased to 2.8% (adj. odds ratio=0.49, 95%CI: .40-.60). Overall length of stay decreased from 491.4 minutes (pre intervention) to 437.2 minutes (post intervention) (adj. mean ratio = 0.84 [95% CI: 0.82 - 0.86, p < .001]). Likelihood to recommend scores increased from an average of 48.48% in the six months prior to intervention to 56.68% post intervention.

The early team assessment model was associated with a significant improvement in time to provider, emergency department length of stay, and patient satisfaction measures.