Implications for practice and research

• A better understanding of the current admission modelling techniques is needed.

• Strategies to address the challenges of efficient patient flow requires a coordinated approach.

Context

There is a global increase in the number of emergency department (ED) admissions due to various factors such as ageing population, comorbidities, winter pressure and emergence of new diseases and infection such as the ongoing COVID-19 pandemic. The impact of rising demand for services include prolonged ED stay, delayed admissions, cancelled elective procedures, lack of bed availability, poor patient experience and pressure on other departments.1–3 To address this growing problem, waiting time is a key measure of performance and a 4 hours target for ED is recommended.2 3