Emergency Department Setting:

  • Suburban/Community Hospital
  • 32,000 annual ED visits
  • 19 ED beds (13 main beds and 6 Fast Track beds)

Challenge:

  • Decision made to improve Turn Around Times (TAT)
  • Reason: This time had steadily increased and needed focus

Efforts:

First step: Address Fast Track turn-around times (TAT)

  • Designated specific nurse and tech to Fast Track
  • Assigned physician/mid-level goal to get time to 90 minutes
  • Followed weekly with PI meetings and monthly at ED physician meetings
  • Best time obtained was 86 minutes

Next focus was admissions:

  • Cooperation from inpatient side through hospital administration
  • Time elements broken into each process:
    • when admission decided
    • when bed available
    • when report called
    • when floor came to get patient
  • ESP Emergency Physician (TAT Champion) was key for day-to-day monitoring and support
  • Each time was evaluated to determine needs for focus with significant improvement in turn-around time (TAT) of inpatient
  • Success in maintaining weekly meetings when needed, involving multidisciplinary team as needed
  • Administrative involvement all helped in this success as well as ongoing PI meetings and interest
  • Support through the ED physician meetings

Results:

  • 95th percentile ED patient satisfaction rank and decreased turn-around times

Figure 1. Emergency Department Volume & Patient Satisfaction

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Figure 2. Emergency Department Volume & Length of Visit

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