ED Patient Flow & Waiting Time
Mary Washington Health System is a sole community provider that provides an
array of health services from obstetrics to cardiovascular care in a very fast growing
community, 50 miles south of Washington DC.
Challenge
In 2004, Mary Washington Health System had an extremely busy Emergency Department with
over 75,000 visits per year and growing each year (today over 90,000). They were
fraught with a number of process issues. Patients were facing 11+ hour wait times.
The walk out rate was as high as 10%. There was a shortage of inpatient beds. The
ED and hospital had a poor image in the community. Not surprising, patient satisfaction
scores were very low. In addition, 68% of all its admissions came from the Emergency
Department. The Emergency Department was the life line to support the growing community's
healthcare needs.
Process
Patient Flow Excellence Accountability Teams (PFEAT) were formed under the direct
oversight of hospital executives. These teams took a holistic approach and included
teams from ED, Scheduling/Admitting, Physicians, Facilities, Housekeeping, Lab,
Radiology, etc. It was recognized that the back up in the Emergency Department was
not solely dependent on its processes and performance but multiple departments working
in concert.
Solution
PFEAT recommendations included process changes, new technology, new capacity and
role changes. The ED installed point of care lab testing and a virtual bed tracking
system. Admitting/discharge nurses were created for each nursing unit, to facilitate
on-time discharges. Mary Washington Health System also added 100 beds to its capacity.
It should be noted that several initiatives such as a discharge lounge and early
discharges were implemented and did not work. Finally, a Patient Flow Management
Dashboard was created manually to support these initiatives and capacity alert plan.
Mediware's InSight™ was brought in as the tool to automate the entire PFEAT
solution, including many previously manual dashboards. InSight™ helped to
improve incorrect and inconsistent data, thereby increasing confidence in the reported
results. InSight™ also provided daily access and visibility to these vital
measures for all teams members.
Result
ED patient wait times decreased 45%. ED walkout rate dropped 60%. Inpatient average
length of stay dropped by .5 days. Patient satisfaction scores soared. Mediware's InSight™'s use has expanded to 289 measures and nearly 150 users. |