Appendix A. Guide to Online Resources Successfully Used by Hospitals to Improve Patient Flow

• The Urgent Matters Toolkit
  This toolkit includes over 50 examples of proven strategies to reduce emergency department (ED) crowding and improve patient flow. Each example includes the strategy, result, hospital demographics, type of staff involved, clinical areas affected, timeline, implementation experience, lessons learned, and cost/benefit estimate. Available at http://urgentmatters.org/toolkit.
• American Hospital Association (AHA) Hospitals in Pursuit of Excellence
  This Web site includes more than 25 case studies that focus on improvements in ED throughput. These case studies focus on the problem, solution, results, background, impact on patient flow, resources expended, sustainability, patient and staff perceptions, and how the strategy meets the Institute of Medicine's six aims. Available at http://www.hpoe.org/.
• Agency for Healthcare Research and Quality (AHRQ) Innovations Exchange
  The Innovations Exchange includes over 75 examples of innovations to improve ED patient flow and reduce crowding. Each innovation includes the what, how, outcomes, and special considerations relative to adoption. Available at http://www.innovations.ahrq.gov/.
• Institute for Healthcare Improvement (IHI)
  IHI features four ED improvement stories and eight emerging content resources focusing on the following categories: how to improve, measures, changes, and literature. In addition, its Web site features several ED patient flow improvement tools, such as an ED hourly patient flow analysis tool. Available at http://www.ihi.org.
• Emergency Nurses Association (ENA)
  ENA's Successful Solutions to Crowding Web site includes eight strategies that led to successful solutions. The solutions are listed under four major areas: access, throughput, ancillary, and disposition. Available at http://www.ena.org.
• American College of Emergency Physicians (ACEP)
  ACEP's Emergency Medicine Crowding and Boarding resources provide information, resources, and examples for a variety of approaches to assist emergency physicians in addressing ED crowding problems by working with hospital administrators, local stakeholders, policymakers, and the public. The members-only section includes crowding case studies. Available at http://www.acep.org/.

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