Date of Conferral



Doctor of Business Administration (D.B.A.)




John Hannon


Some hospital emergency departments (EDs) are negatively affected by extended patient wait times, resulting in reduced hospital profitability. Therefore, it is critical hospital leaders understand factors impacting ED average patient wait times. Grounded in the business process improvement theoretical framework, the purpose of this causal comparative study was to examine the impact of an ED rapid evaluation unit (REU) patient flow model and emergency severity index (ESI) on average weekly patient wait times. Data collection comprised a census of 26 archival data records pre and postimplementation of an ED REU patient flow model from a hospital ED in Upstate New York from April 18-October 18, 2015, and October 19, 2015- April 19, 2016. The results of the mixed-method ANOVA indicated there was a significant time (pre and postimplementation) and emergency severity index interaction effect: Wilks lambda = .55, F(2, 24) = 9.86, p = .001, partial eta squared = .45. There was also a main effect for time: Wilks lambda = .72, F(1, 25) = 9.74, p = .005, partial eta squared = .28. In addition, there was significant main effect for ESI: Wilks lambda = .084, F(2, 24) = 130.28, p < .001, partial eta squared = .92. At ESI triage level 2, there was less difference in the door to provider time than there was for ESI triage level 4. The implications for social change include the potential to reduce patient wait times; improving on patient health outcomes and satisfaction.