Emergency Department Operations Management (Information Paper)

An information paper developed by members of ACEPs Emergency Medicine Practice Committee, March 2004

A compendium of operations management resources and information that can be utilized to improve effective hospital and emergency department (ED) function.


The purpose of this web based module is to provide a compendium of operations management resources and information that can be utilized to improve effective hospital and emergency department (ED) function for ACEP members. Five modules have been developed:

  1. The Nature of ED Services
  2. The Science of Service Quality
  3. The Role of Metrics in Managing Clinical Operations
  4. The Dynamics of Organizational Change
  5. Service Management Tools


The clinical practice of emergency medicine and the administration of an ED ultimately constitutes the provision of a customer service, albeit a professional one. Within the world of business, there are a number of theories and models on the management of a service enterprise, most notably those of Juran, Baldrige, as well as the “Six Sigma” approach. One body of expertise that seems particularly applicable to emergency medicine services is Operations Management. Operations management utilizes a systems approach to the provision of a service, including the definition of the particular characteristics of a service (such as the service package, the service process, and the virtual value chain embedded in that service), structured planning for service quality, appropriate service metrics, selected management tools, and consideration of strategies for interdisciplinary collaboration, as well as cultural change. Ultimately, the value of an operations management approach to management of the ED is explicit consideration of all salient elements of the service process in a systematic manner. In doing so, it is important to link clearly the service function to the institutions mission/strategic plan, as well as the expectations and needs of ED patients who are served there.

Asplin (A Conceptual Model of Emergency Department Crowding. Ann Emerg Med. 2003; 42:173-180), describes a three-phase “input – throughput – output” model of emergency services. This model is applicable to the challenge and solutions to the problem of ED overcrowding that has occurred in many communities in the US.

The information paper includes the following sections:

Created by the Emergency Medicine Practice Subcommittee on Operations Management
March 2004

Randall B. Case, MD, MBA, FACEP, Committee Chair
Louis S. Binder, MD, FACEP, Subcommittee Chair
Mark W. Brodeur, MD (EMRA)
Timothy A. Burrell, MD, MBA, FACEP
Edward S. Cho, DO (EMRA)
Luis F. Eljaiek Jr, MD, FACEP
Shkelzen Hoxhaj, MD
Stephen R. Pitts, MD, MPH, FACEP
Carol Rogala, DO, FACEP

Reviewed by the ACEP Board of Directors
April 2004

Emergency Department Operations Management - An Information Paper 

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