Children’s Hospital Orange County operates a 31-bed emergency department that cared for 110,000 patients in 2025 and had an average daily census of 302 patients. Despite high patient

Children’s Hospital Orange County (CHOC)

volumes and limited bed capacity, fewer than 1 percent of patients left prior to receiving a medical screening exam.

Two key initiatives designed to reduce wait times and improve patient flow contributed to the low left without being seen rate. The first targeted low-acuity patients by assigning dedicated registration staff and triage nurses to expedite the intake and assessment process. This streamlined approach reduced the average length of stay for low-acuity patients from 153 minutes to 126 minutes.

The second initiative involved implementation of a physician in triage model during periods when all treatment rooms were occupied. The PIT area was staffed by a physician, two registered nurses and an ED technician, allowing patients to be evaluated and treated sooner. Additional nursing support roles were introduced to improve throughput during high-volume periods. A lobby reassessment nurse also monitored waiting patients, identified changes in condition and proactively engaged families experiencing prolonged waits to help reduce the likelihood of patients leaving without being seen.