ANALYZING FACTORS AFFECTING THE LENGTH OF STAY (LOS) IN THE EMERGENCY DEPARTMENT OF A TERTIARY CARE HOSPITAL IN DELHI USING FAILURE MODE AND EFFECTS ANALYSIS (FMEA)

Background: Length of stay (LOS) in the Emergency Department (ED) is a critical indicator of efficiency, resource utilization and quality of emergency care. Prolonged LOS contributes to crowding, delays in treatment, and potential compromise of patient safety. Objectives: To identify factors associated with prolonged LOS in the ED of a tertiary care hospital in Delhi and to apply Failure Mode and Effects Analysis (FMEA) to prioritize high risk process failures. Methods: A descriptive observational study was carried out in the ED of a tertiary care hospital in Delhi from November 2021 to February 2022. LOS was defined as the time interval between ED registration and final disposition. Process mapping, review of ED records, and structured data extraction were used to capture patient flow and reasons for delay. A multidisciplinary team conducted FMEA across key ED sub-processes; severity, occurrence and detectability scores were assigned, and Risk Priority Numbers (RPNs) were calculated.