Skip to content

Flow and bottlenecks

Find where ED time is lost with EDFlow: flow segments from arrival to departure, the per-visit bottleneck flag, the period bottleneck ranking by excess minutes, heatmaps, trends and capacity drivers.

Flow and bottlenecks: median time per segment of the visit, with the slowest segments flagged and ranked.
WebCaptured from build 7c7f41f on September 27, 2026

Segments

Every visit is split into segments:

SegmentFromToPatients see an estimate
S1 Arrival → triageArrivalTriageYes
S2 Triage → seenTriageSeenYes, by stream and CTAS
S2n Triage → PIA (NACRS)TriagePIANo
S3 Seen → first testSeenFirst orderNo
S3b Seen → decision, no testsSeenDecisionNo
S4 TestingSeen or first orderLast result complete before the decisionNo
S5 Results → seen againResults completeReassessment or decisionYes
S5o ObservationStartEndThe plan only
S6 Decision → cleared to leaveDecision (home)Cleared, or departureYes
S6c Cleared → leftClearedDepartureNo
S6a BoardingDecision (admit)DepartureOnly where the site allows it
S7 ConsultRequestedSpecialist seenYes

The bottleneck flag (per visit)

For each segment, EDFlow divides its duration by the p90 for its start bucket (site, weekday, hour). The visit's bottleneck is the segment with the highest ratio, when that ratio is 1 or more. The board's Bottleneck column shows it, and Time in stage is toned typical (below p75), longer (p75 to p90) or beyond (above p90).

The bottleneck ranking (period)

For each segment, excess minutes per visit = the sum of time beyond each visit's bucket p50, divided by the number of visits. The top segment is labelled Main bottleneck. Capacity drivers (boarder-hours, occupancy, physician hours) are shown next to it, so access block isn't read as an ED problem.

Charts

  • p50 and p90 for each segment against its benchmark.
  • Heatmaps (hour × weekday, 7 × 24 cells) for arrivals, door-to-doctor, LOS and LWBS rate.
  • Weekly trends for door-to-doctor, LOS by disposition, results to reassessment and boarding.
  • A histogram for each segment, and a breakdown by CTAS group and disposition.

Using it well

  • Start with the main bottleneck and its capacity drivers.
  • Results → seen again (S5) is often where a "Seen again" habit or a results-back digest helps.
  • Compare with the pre-pilot baseline using the same definitions.

Last updated on

Was this page helpful?

On this page

SegmentsThe bottleneck flag (per visit)The bottleneck ranking (period)ChartsUsing it wellRelated