Improving emergency department efficiency through integrated bed management and radiology workflow optimization: An organizational intervention study

Background and aim: Emergency Department (ED) overcrowding is a major challenge for healthcare systems worldwide and is associated with delayed diagnosis, prolonged waiting times, and increased risk of adverse clinical outcomes. Organizational factors such as inefficient bed management and delays in diagnostic imaging contribute significantly to ED congestion. This study describes the implementation of an organizational model aimed at improving patient flow, optimizing hospital bed turnover, and enhancing radiology workflow in the Emergency Department of “M. Dimiccoli” Hospital in Barletta (Italy). Methods: A quasi-experimental organizational improvement study was conducted over six months in 2024. The intervention included the implementation of a real-time digital dashboard based on the National Emergency Department Overcrowding Score (NEDOCS), the introduction of a structured hospital bed reserve system for emergency admissions, the appointment of a dedicated nursing coordinator for bed management, and optimization of radiology workflow through prioritization of urgent imaging requests and improved ED–radiology coordination. Operational indicators, including waiting times, ED overcrowding levels, bed availability, and diagnostic imaging turnaround times, were monitored during the study period. Results: Implementation of the organizational model enabled continuous monitoring of ED congestion and improved coordination between the emergency department and inpatient units. The structured bed reserve system facilitated hospital admissions and reduced delays in bed allocation. Improved integration between emergency physicians and radiology services supported a stable and efficient radiology workflow within the emergency care pathway, facilitating timely diagnostic evaluation and clinical decision-making. Conclusions: Integrated hospital management strategies combining digital monitoring tools, structured bed management, and optimized radiology workflow can significantly improve emergency department operational efficiency. The organizational model described may represent a replicable framework for hospitals seeking to address ED overcrowding and improve patient care processes.