Trim the Wait, Open the Gait : Better ED Rate

Objectives: Emergency Department (ED) length of stay (LOS; EDLOS) is a widely accepted indicator of healthcare quality, patient flow, and operational efficiency. Prolonged EDLOS contributes to overcrowding, treatment delays, increased morbidity and mortality, and reduced patient satisfaction. Continuous monitoring of EDLOS is therefore essential for quality improvement in emergency care. Material and Methods: A retrospective quality-improvement study was conducted in the ED of a tertiary care multispecialty hospital. Data from August–September 2024 were analyzed as the pre-intervention phase ( n =3,678), while August–September 2025 represented the post-intervention phase ( n =3,710). Eligible patients included all ED attendees with a length of stay greater than 30 minutes. Interventions implemented following the initial review included expansion of bed capacity, increased physician staffing, introduction of ED coordinators, and focused monitoring of diagnostic and consultation turnaround times. Average EDLOS and compliance with institutional benchmarks were compared between the pre-intervention and post-intervention periods. Results: A total of 7,388 ED encounters were included in the study. Average EDLOS decreased from 3.05 and 2.42 hours during August and September 2024 to 1.08 and 1.25 hours during August and September 2025, respectively. Mean EDLOS improved from 2.74 hours during the pre-intervention phase to 1.17 hours post-intervention, representing a reduction of 57.3%. Compliance with the institutional benchmark of EDLOS less than four hours improved from 78% during the pre-intervention period to 93% following the implementation of operational interventions. Conclusion: Targeted operational interventions significantly improved ED efficiency and reduced EDLOS. Expansion of capacity, improved staffing, multidisciplinary coordination, and continuous performance monitoring contributed to sustained improvements in patient flow and service delivery.