All ETDs from UAB

Advisory Committee Chair

Stephen J O'Connor

Advisory Committee Members

James Booth

Kristine R Hearld

Amy Landry

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


This study investigates hospital strategies used to inform patients of anticipated wait times in the Emergency Department (ED) and the association of such strategies with patient throughput efficiency. When hospitals are inefficient in ED patient throughput, conditions of overcrowding often occur. Overcrowding of the ED is a problem for many hospitals. When such conditions exist, there is evidence in the literature that it leads to lower patient satisfaction, care quality, and financial position of the hospital. Therefore, improving patient throughput efficiency is a priority for hospitals. To improve patient throughput efficiency, hospitals use a variety of strategies. This study focuses on two wait time communication strategies of posting ED wait times on the hospital website and the use of ED reservation systems. Through application of Rational Choice Theory, it is expected that patients who are informed of anticipated wait times will make rational decisions related to visiting a potentially overcrowded ED. Thus, engaged patients make decisions that can contribute to improved ED efficiency. The question of this research study is "Do ED wait time communication strategies improve patient throughput efficiency?" This study sample includes acute care hospitals in Florida and the ED throughput efficiency metrics from the Center for Medicare and Medicaid Services (CMS) Hospital Compare data sets to contrast the performance of hospitals that use the study strategies. The results of the study indicate that posting ED wait times on the hospital website has a statistically significant association with ED efficiency. However, the use of reservation systems does not have a statistically significant association with ED efficiency. Further, the control variables of hospital licensed bed size, metropolitan location, percent of population without health insurance, and percent of population Medicaid eligible have a statistically significant association with ED efficiency. Consistent with expected behavior related to Rational Choice Theory, this study supports that informed patients will make logical decisions related to if and when to visit an ED for care and therefore contribute to improved throughput efficiency.



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