emergency department top tips
LEFT WITHOUT BEING SEEN
Did you know that every year in the US more than 1.5 million people who come to the ER for help leave without being seen??
This serious problem, exacerbated by the pandemic, delays care for untreated medical conditions and amounts to significant lost revenue for hospitals who need it desperately to support their staff.
I think we can all agree that ensuring patients receive care when they need it is absolutely critical to effectively support the communities we serve. By working together to streamline emergency department processes, we can help ensure that no patient is left without care they need to live a healthy and fulfilling life. We can do better!
#emergencymedicine #leftwithoutbeingseen #emergencydepartment #operationsmanagement
DOCTOR STAFFING ALIGNMENT
When preparing to provide emergency care for patients, first we must ensure staff are available at the right time! Aligning physician staff schedules with patient arrival rates is a critical first step, without which patients will very likely be forced to wait too long for emergency care, ultimately causing them to leave the ER before receiving the care they need.
For example, if only 2 patients arrive on a Monday morning between the hour of 4:00 AM and 5:00 AM, 1 provider should be able to greet each of them and enter orders without delays. However, in that same afternoon between the hour of 2:00 PM and 3:00 PM, 15 new patients arrive. The inevitable backup caused by the workload mismatch for the overloaded (and probably frustrated) single provider will cause such a backlog it will create a surge that will likely not decompress until the following morning. This scenario is of course a clinical care risk, but also a revenue and reputational risk for the Emergency Room.
When creating provider schedules, always review historical patient arrival rates by day of week and time of day to attempt to plan for this variation. Your results will be even better if you interview providers to learn more about their daily workflow considerations!
#EmergencyCare #PhysicianSchedules #PatientArrivalRates #WaitTimes #ProviderScheduling #WorkflowConsiderations
NURSE STAFFING ALIGNMENT
When creating the ER nursing schedule, it is critical to consider workload via patient census data, which varies based on day of the week and time of day. Ensuring consistent staff-to-patient ratios is the first way to support high-quality patient care delivery, whether it's a tranquil Sunday morning or a manic Monday evening.
Top Tip: Don't forget to include boarders/holds in workload calculations!
#EmergencyDepartment #NursesRock #ERNurse #NurseLeaders #StaffingSolutions
PULL TILL FULL
Triage is a process, not a place! In high performing Emergency Departments, the concept of "pull till full" has been commonplace for more than a decade.
Immediate bedding is the practice of moving patients back into a room before they find a seat in the waiting room. This creates the most efficient care process and SIGNIFICANTLY reduces the number of patients who leave without being seen, as most who leave are simply tired of waiting. Emergency Departments occasionally get caught up on the idea of triage as a place. Remember that triage can easily take place anywhere - including in a treatment room!
Immediate bedding not only constantly works to optimize physical space, but it also demonstrates our commitment to providing timely and patient-centric care. Let's redefine emergency care and ensure that every patient who walks through your doors receives the care they need… when they need it!
#ImmediateBedding #TriageIsAProcess #EmergencyMedicine #ERbestpractices
FAST TRACK
What time is your Fast Track open on Mondays?
High performing Emergency Departments typically utilize a "Fast Track" for low acuity patients to ensure all are seen in a timely fashion and fewer leave without being seen. The Fast Track is optimized for low acuity patient treatments, ensuring timely and effective care while optimizing resources.
#EmergencyCareOptimization #FastTrackApproach #PatientCentricER #EfficientCare
ER DASHBOARD
Is course correction needed in your ER?
A dashboard with meaningful metrics and trending is critical for self-awareness and performance improvement. Consider creating a heat map and metric trending visuals to immediately identify strengths and opportunities. From here, monitor data monthly to target improvement initiatives that align with your goals.
For more dashboard considerations, check out our "Nobody Cares About Your Dashboard" article!
#emergencydepartment #erdashboard #performanceimprovement #emergencymanagement