Literature review identifies causes of delayed length of stay in emergency department, suggesting systemic interventions.
Background: Prolonged emergency department (ED) length of stay (LOS) is a key indicator of hospital service efficiency and quality. Extended LOS can lead to decreased patient satisfaction, increased clinical risk, and higher workload for medical staff.Purpose: To identify and analyze the factors contributing to delayed LOS in ED using the input–throughput–output model.Methods: A total of 11 national and international articles from 2020 to 2024 were reviewed. Each study was analyzed based on the type of contributing factor and dominant findings.Results: Input factors include patient age, gender, acuity level, and transportation access. Throughput factors consist of triage, diagnostic examinations, and medical consultations. Output factors are mainly related to inpatient bed availability and patient transfer systems. Several studies also highlighted the role of staff training and family knowledge in influencing LOS.Discussion: Delayed ED LOS is a multidimensional issue that requires systemic interventions. Technology-based innovations, service flow optimization, and public education should be integrated into sustainable ED management strategies.
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Nyoman Tri Yogantara (2025) studied this question.
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