Harlaching’s new system cuts emergency department waits

A redesigned emergency department at Munich’s Harlaching hospital is treating patients much faster, and its waiting room is often empty, according to the hospital. BR reports that the changes have drawn questions about how the system works and whether other hospitals can adopt it.

The hospital has been testing the concept for about a year. It was developed by Tim Flasbeck, now director of in-hospital emergency medicine at the municipal Munich Clinic. Earlier in his career, he said, paperwork and the search for beds took time away from patient care. He later developed a model for organising emergency departments, drawing on discussions with nursing staff. A department he redesigned in Cottbus is considered a model project.

Flasbeck says an emergency department needs sufficient space and resources, and that departments within a hospital must work well together. At the newly built Harlaching hospital, the team chose rooms it considered more suitable than those originally planned for the emergency department.

The system also coordinates each step of care, from initial assessment and treatment to admission to a ward or transfer elsewhere. Flasbeck says this depends on bed management based on statistical experience.

Another feature is a holding area where patients can sit or lie down after initial treatment while staff keep them in view. Some BR24 readers questioned whether this simply shifts pressure on beds and nursing staff to another room. Flasbeck said patients feel better cared for when they are visible to nursing staff than when they feel overlooked in a waiting room.

Matthias Klein, head of the emergency department at the University Hospital in Munich-Großhadern, praised the improvements and said his team was studying the changes. But he noted that hospitals differ in their buildings and internal organisation, and that some measures, including a holding area, were already in place in Großhadern.

Markus Wehler, head of the emergency department at Augsburg University Hospital, also said there was no single blueprint for every hospital. He cited emergency departments temporarily notifying the ambulance coordination centre that they cannot accept more patients because of overcrowding. Munich Clinic hospitals have significantly reduced such notifications under the new system, he said.