Tension in the Emergency Department? The Impact of Flow Stage Times on Managing Patient-Reported Experiences and Financial Productivity

Healthcare providers are expected to compete across multiple performance dimensions, thereby managing both their financial productivity and the patients' "in process" experiences. This fact creates tensions in some healthcare settings, as providers need to provide high-quality care and positive customer experiences while still being financially responsible. Increasingly, these goals create pressures that require emergency departments (EDs) to generate operational efficiencies to improve how healthcare providers manage patient flow at different service stages and to deliver better care for an increasing number of patients at a more reasonable cost. From the perspective of managing patient process flow stage times, this article uses online ratings and secondary source data to examine how EDs can simultaneously improve both experiential and financial productivity performance. Our findings strongly indicate that EDs may be able to leverage the physician-directed evaluation time stage to improve departmental efficiencies in both performance areas. However, the diminishing value of evaluation time and the time a patient spends in pre-care for ED services are necessary contingencies to consider. Finally, to illustrate the practical relevance of these findings, we explore the perceived tradeoffs of managing the different patient flow time stages.