Continuous flow models in urgent and emergency care

Winter is not yet fully upon us and already emergency departments in the UK are struggling with unprecedented levels of overcrowding. Record numbers of patients are waiting for longer than 12 hours for an inpatient bed, with some spending days in the emergency department. Ambulances are unable to offload patients for want of space, impeding their ability to respond to the most urgent calls.1 So serious is the situation that it has been suggested as the main cause of the spike in excess non-covid deaths seen over the summer.2One possible solution currently attracting interest is the continuous flow model, first introduced in North America in the late 1990s.3 Also known as full capacity protocols, these effectively mandate that a set number of patients are moved at set times from the emergency department to inpatient wards, regardless of whether a bed is available. This might mean putting an extra patient in…
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