Good Medicine: Healing a Hospital’s Struggling ED
technical writing
Description
Good
Medicine: Healing a Hospital’s Struggling ED
A 205-bed general
medical and surgical hospital in a medically underserved community in Chicago
was struggling with an underperforming emergency department (ED). Higher-than
normal volume left patients waiting more than two hours to be seen by a doctor
and almost eight hours to be admitted. Nearly 8 percent left without being
treated at all. The poor experience resulted in patient satisfaction scores in
the 4th percentile, and dragged down overall hospital performance.
The parent network had
recently revamped operations at another hospital’s ED and decided to try a
similar approach at the hospital in question. They brought in Integrated
Project Management, Inc. (IPM) to organize and orchestrate an ED optimization
program.
IPM met with the ED
medical director and hospital chief nursing executive to assess the current
situation. The goal was to reduce delays in key performance areas, including
the ED’s “left without treatment” (LWOT) numbers and increase patient
satisfaction levels.
Using a two-phased
approach and close collaboration with the hospital team, IPM first led a short
engagement to determine the scope of the initiative, identify and prioritize
projects within the program, estimate their size, and confirm team members. The
second phase involved leading the project teams to prepare the detailed plans
and implement them and ultimately, help get the stressed ED on track.
The process resulted in
a complete redesign of the ED structure, from adding an RN and care provider to
the triage area, to expanding the floor design with an additional nurses’
station.
Instead of assigning
individual nurses to a block of rooms, the new structure created teams of
doctors, nurses, and techs (named the “blue” and “red” teams) who would provide
care for a designated area. The team model focuses on patient safety and
allowed for proper staffing ratios throughout the ED. Other changes included
modifying workflow (e.g., establishing the “fast track” rooms next to triage),
improving the organization and location of supplies, and changing metric
tracking and communication
