Blueprint of the ideal emergency department layout

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In an ideal situation, each patient group in the ED is prioritized based on the degree of urgency so the different patient flows never intersect"

Every hospital has different requirements for the ideal emergency department (ED). Philips Healthcare Transformation Services (HTS) organized a round-table session with a group of experienced doctors and nurses. The discussion focused on the question "How can an ED be set up to handle an increase in patient intake?" The group came up with several requirements to ensure an ED will run as smoothly as possible. Article one of this three-part series touches on several of the most important considerations for the ideal ED and this second article addresses the ideal ED layout, given the available space. In article three, we combine the ideal blueprint with our field expertise to help determine what is actually feasible in practice and provide a checklist, indicating initials steps to take towards your ideal ED.

The building structure of the hospital shapes contemporary EDs

The round table discussion highlighted the fact that EDs about to undergo refurbishment often have a wish list that isn’t compatible with the existing building structure. It may be that a space can’t be altered due to historic landmark designation, or the space may have technical limitations that prevent significant rebuilding. An example of the latter might be expensive lead walls in the radiology department, which often mean any relocation is simply too costly. Therefore, a crucial part of Philips' consultancy work is to optimize EDs within the existing building parameters.


Philips HTS has supported several EDs through this type of optimization. Requests and requirements vary hugely from one project to the next, so we offer customized solutions that retain the existing building structure. Sometimes incremental changes, like relocating the triage room, are key to process improvement. Often, the answer involves fine-tuning ED processes in conjunction with other departments, such as acute admissions. Both result in enhanced patient throughput.

Streamlining the different patient flows is crucial

In an ideal situation, each patient group in the ED is prioritized based on the degree of urgency so the different patient flows never intersect. Self-referring patients tend to be stable and therefore need less attention than unstable, acute patients, including those who have suffered trauma. Streamlining—or, even better, separating—these patient flows is an important factor in creating structured work processes. Technology is one way to keep those flows separate. Real-time remote monitoring is an option for stable patients who have less acute care requirements and who can wait in a decentralized location for exam results and potential treatment. Conversely, patients who are seriously ill and unstable must remain close at hand because care providers require constant access to their vital signs. Our blueprint for the ideal ED provides a waiting area with high-quality, real-time monitoring, tailored to the specific needs of a diverse range of patient groups. This approach allows for excellent service for every patient to the ED.

The importance of a well-positioned radiology department

Another way of separating patient flows is to redesign the physical layout in and around the ED. Unstable and more acute patients are often referred to radiology, so it is important that this patient group be diagnosed as quickly as possible. The logical solution is to move the ED closer to where diagnostic services are provided. Many hospitals have one central radiology department, which means pathways for less acute, acute and trauma ED patients often cross as they are moved toward radiology. This can be solved by providing radiology services at two separate locations near the ED, keeping patient flows separated. For example, both acute and less acute patients who require X-ray services can be segregated into one area, separated from a second area designated specifically for acute trauma patients and the complex diagnostic services they require.

Align the arrival procedure for ambulances

As part of ED consultancy engagements, Philips often analyzes the arrival procedures for ambulances, using data to map this process and identify areas for improvement. Initial triage in the ambulance can help the ED direct patients to a specific entrance, separating acute, unstable patients from stable and less acute patients at an early stage. This helps ensure that the department runs smoothly, an important part of the blueprint for the ideal ED.

Our work in the ED

Blending practical knowledge and data-based insights helps us to work with our clients to design their ideal department. In-depth analysis to find the root causes of obvious problems enables us to rapidly identify solutions that have significant impact. Continuous monitoring of the modified work processes is also important, as it highlights progress that is made and where adjustments are needed.

Getting started

Whether you are designing an ED from scratch or making changes to an existing one, there are some elements that are easy to address. There is a checklist in our third article, so you can quickly assess areas that require changes or improvement and start working toward your ideal ED.

Streamlining the different patient flows is crucial."

Other articles in this article series

About the author

Meike Sloet

Meike Sloet

Healthcare consultant Benelux region

Meike works on strategic and process-related issues in healthcare, with a strong focus on improving patient care while considering the increasing cost of care. Addressing staff well-being and ensuring it is incorporated into healthcare transformation is vital and an important element for her. Meike collaborates closely with clients to deliver data-based change in healthcare.
Other articles in this article series

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