The Impact of Process Mapping Techniques on Emergency Department Efficiency and Quality of Care: A Systematic Review
No Thumbnail Available
Date
2025-05-28
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Saudi Digital Library
Abstract
Abstract
Background: Emergency departments worldwide face operational challenges that impact patient
care quality and efficiency. Process mapping techniques have emerged as potential quality
improvement strategies, yet comprehensive evidence of their effectiveness in emergency
department settings remains limited.
Objective: To systematically review the impact of process mapping techniques on emergency
department efficiency and quality of care.
Methods: Article search was conducted at five databases (PubMed, Web of Science, Scopus,
MEDLINE, ACM) from August 2024 to January 2025, with no date restrictions. Studies were
included if they explicitly applied process mapping techniques in emergency department settings
and reported efficiency or quality outcomes. Two reviewers independently screened studies and
extracted data. Study quality was assessed using the SQUIRE 2.0 checklist. Due to heterogeneity
in study designs and outcome measures, a narrative synthesis was conducted.
Results: Twenty-four studies met inclusion criteria, representing diverse settings across 12
countries. All studies reported positive efficiency outcomes, with process mapping techniques
demonstrating median reductions of 20% in emergency department length of stay (range: 3-68%)
and 54% in door-to-doctor wait times (range: 29-78%). Left without being seen (LWBS) rates
decreased by an average of 46% in seven of eight studies, with one study reporting a slight, nonsignificant
increase. Quality of care indicators showed improvements in patient satisfaction in all
three studies measuring this outcome, with no studies reporting negative impacts on clinical safety
measures. Value Stream Mapping, simulation-enhanced approaches, and comprehensive Lean
methodologies demonstrated the most substantial improvements across multiple domains.
Conclusions: Process mapping techniques consistently improve emergency department efficiency
without compromising quality of care across diverse healthcare settings. The evidence strongly
supports adopting these techniques as effective quality improvement strategies, particularly for
departments facing operational challenges. Future research should focus on comparative
effectiveness studies and long-term sustainability evaluations.
Description
Keywords
process mapping, emergency department, quality improvement, lean methodology, value stream mapping, patient flow, length of stay, systematic review