Date of Conferral



Doctor of Healthcare Administration (D.H.A.)


Health Services


Sally Willis


Currently, emergency department overcrowding has negatively impacted hospitals' financial, operational, and organizational performance globally. A contributing factor to emergency department overcrowding includes the delay of the throughput process for patients who have a time-sensitive diagnosis and are admitted to the emergency department. This causes adverse hospital outcomes such as longer length of stays and increase hospitalization cost. This study utilized secondary data to address a relationship between admitted patients who have time-sensitive diagnoses such as chest pain and chronic obstructive pulmonary disease within North Carolina emergency departments and length of stay, utilization of services, and overall hospital cost. The conceptual framework for this study is the Donabedian model, which evaluates a hospital's structure, process, and outcome to improve the quality of care. The sample size for this quantitative study included a total of 17,328 patients admitted within North Carolina Emergency Departments with time-sensitive diagnoses such as chest pain and chronic obstructive pulmonary disease in 2017. The statistical analysis used for this study was a univariate regression and ANOVA model. The results from this study indicated there was a significant relationship among admitted patients within emergency departments of North Carolina with time-sensitive diagnosis and length of stay, utilization of services cost, and overall hospital cost. This study will assist in improving hospital outcomes by addressing influential factors of emergency department crowding, which will promote optimal health, decrease utilization of services and length of stay while reducing emergency crowding leading to positive social change.