Improving Emergency Care Through Better Patient Flow

The Timely Emergency Care Collaborative (TECC), led by the Victorian Department of Health in partnership with the Institute for Healthcare Improvement, recently concluded a multi-year initiative aimed at reducing delays in emergency departments across 14 hospitals. This project, grounded in evidence-based change principles, tackled one of the most pressing challenges in EDs nationwide: patient flow. By focusing on system-wide collaboration and the role of early clinical decision-making, the TECC demonstrated measurable improvements in emergency department length of stay - a critical metric for both patient outcomes and operational efficiency. 

Key learnings from the initiative included the powerful impact of early senior clinician involvement, structured communication like flow huddles, and the recognition that ED delays are often a symptom of broader hospital-wide issues. Clinician-led teams that embraced these changes and fostered a culture of accountability were able to drive better outcomes and smoother transitions for patients moving through the hospital. 

Some of the key stats:  

20–30% reduction in ED length of stay
Several participating hospitals reported significant reductions in average emergency department length of stay, with some achieving up to 30% improvements after implementing early decision-making and flow initiatives. 

Up to 50% faster admission decision times
Sites that introduced early senior medical officer (SMO) assessments saw markedly faster disposition decisions; in some cases reducing time to decision by almost half. 

Reduced ED 'access block' rates 
A number of teams reported a noticeable decrease in the number of patients waiting 8+ hours in the ED before inpatient admission - a key indicator of hospital-wide flow improvements. 

Locum doctors working in EDs across Australia may walk into different systems each week, but understanding the drivers of flow, championing early decision-making, and contributing to communication and escalation processes can make a real difference when on shift. 

As more hospitals adopt flow-focused strategies, locum emergency physicians, registrars and FACEMs who are proactive, adaptable and aligned with these best practices will be better positioned to contribute meaningfully and deliver high-quality care. 

Read the full research report on the Health Victoria website.