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. 2021 Aug 20;18(16):8814.
doi: 10.3390/ijerph18168814.

Process Improvement Approaches for Increasing the Response of Emergency Departments against the COVID-19 Pandemic: A Systematic Review

Miguel Angel Ortíz-Barrios  1 , Dayana Milena Coba-Blanco  1 , Juan-José Alfaro-Saíz  2 , Daniela Stand-González  1
Affiliations

Process Improvement Approaches for Increasing the Response of Emergency Departments against the COVID-19 Pandemic: A Systematic Review

Miguel Angel Ortíz-Barrios et al. Int J Environ Res Public Health. .

Abstract

The COVID-19 pandemic has strongly affected the dynamics of Emergency Departments (EDs) worldwide and has accentuated the need for tackling different operational inefficiencies that decrease the quality of care provided to infected patients. The EDs continue to struggle against this outbreak by implementing strategies maximizing their performance within an uncertain healthcare environment. The efforts, however, have remained insufficient in view of the growing number of admissions and increased severity of the coronavirus disease. Therefore, the primary aim of this paper is to review the literature on process improvement interventions focused on increasing the ED response to the current COVID-19 outbreak to delineate future research lines based on the gaps detected in the practical scenario. Therefore, we applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform a review containing the research papers published between December 2019 and April 2021 using ISI Web of Science, Scopus, PubMed, IEEE, Google Scholar, and Science Direct databases. The articles were further classified taking into account the research domain, primary aim, journal, and publication year. A total of 65 papers disseminated in 51 journals were concluded to satisfy the inclusion criteria. Our review found that most applications have been directed towards predicting the health outcomes in COVID-19 patients through machine learning and data analytics techniques. In the overarching pandemic, healthcare decision makers are strongly recommended to integrate artificial intelligence techniques with approaches from the operations research (OR) and quality management domains to upgrade the ED performance under social-economic restrictions.

Keywords: COVID-19; emergency department; healthcare; process improvement; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Search algorithms used in the literature review.
Figure 2
Figure 2
PRISMA flow diagram.
Figure 3
Figure 3
Risk of bias graph—an analysis of the 8 evaluation criteria.
Figure 4
Figure 4
The most popular primary objectives pursued by EDs during the COVID-19 pandemic.
Figure 5
Figure 5
The techniques used to address the most popular objectives pursued by ED decision makers during the pandemic.
Figure 6
Figure 6
Number of papers evidencing the use of process improvement approaches for ramping up the response of EDs against COVID-19 (Period: January 2020–April 2021).
Figure 7
Figure 7
The journals most contributing to the evidence base.
See this image and copyright information in PMC

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