Tools: ED Throughput
Tools: ED Throughput | ED Treatment Path | ED Clinical process | Other ED | Inpatient Flow | Patient Satisfaction | ALL
Tool / Best Practice (Alphabetical order)
Contributing Hospital / Description
30 Minute
ER Promise (Categories: ED
Throughput, ED Treatment Path, Patient Satisfaction)
Atlantic General Hospital - Staff wanted to improve the time it took
for a patient to begin treatment to 30 minutes and created the '30 Minute ER
Promise.' It guarantees that a patient will be placed in an exam room or begin
to receive treatment, such as pain medication, x-ray, or lab tests, within
30 minutes of arrival at the hospital. (supporting
document (PDF))
Admission Folder (Categories: ED
Throughput)
Methodist Hospital - An admission folder has helped simplify the
admission process and reduce unnecessary delays in admitting patients at
Methodist Hospital.
Bridging Orders (Categories: ED
Throughput, Inpatient Flow)
St. Luke's Hospital - Hospital wanted to test whether an expedited
admissions protocol would reduce ED turnaround times. An ED Nurse receives
bridging orders for patients to be admitted and gives those orders to the
admission nurse who finds a room for the patient, bypassing an admitting
physician. The protocol decreased ED turnaround time by 20 percent.
Care Management
Department Improvement (Categories: ED
Throughput, Inpatient Flow)
Albert Einstein Medical Center - The hospital's leadership
proposed several changes to the Care Management Department, which supported
these changes as they would ultimately make their work more efficient.
Care Management
Unit (Categories: ED
Throughput, ED Treatment Path, Patient Satisfaction)
Grady Health System - A Care Management Unit at Grady Health System
treats patients with specific common diagnoses in the ED.
Code Purple (Categories: ED
Throughput, Other ED, Inpatient Flow)
North Shore Medical Center - North Shore Community Hospital actively
engages staff throughout the facility to help avoid diversion when the ED becomes
over-crowded.
Collaborative
to Improve Patient Flow (Categories: ED
Throughput, Inpatient Flow, Patient Satisfaction)
Carondelet St. Mary's Hospital - A multi-disciplinary team at Carondelet
St. Mary's Hospital set out to improve patient flow not just in the ED, but
throughout the hospital.
Discharge
Resource Room (Categories: ED
Throughput)
Regional Medical Center, Memphis - The MED created a Discharge Resource
Room (DRR) to address the problem of patients remaining in the ED after being
discharged. (supporting
document (PDF))
ED Flow Manager (Categories: ED
Throughput)
Moses H. Cone Memorial Hospital - Flow managers remotely monitor
patient flow at each of the three hospitals in the Mose Cone Health System,
identifying bottlenecks and looking for ways to fix these bottlenecks.
ED Information
System (Categories: ED
Throughput)
MetroHealth Hospital - A new ED information system helped MetroHealth
Hospital better manage patient flow and decrease patient throughput times.
ED Registration
Kiosks (Categories: ED
Throughput)
Parkland Memorial Hospital - Parkland Memorial Hospital installed
three registration kiosks, called MediKiosks, in the ED's triage area.
When patients arrive at the ED, they spend several minutes entering the necessary
registration information on a computer screen. (supporting
document (PDF))
Enhanced
Triage Area (Categories: ED
Throughput, ED Treatment Path, Patient Satisfaction)
Northwest Community Hospital - Northwest Community Hospital put in
place an Advanced Triage Care Area, in which lower-acuity patients would be
assessed, treated, and discharged having to wait for an ED bed.
Expanded
Observation Unit (Categories: ED
Throughput)
University of Rochester Medical Center - University of Rochester
Medical Center expanded its observation unit by more than four times in order
to enable more patients to be admitted to the observation unit rather than
taking up valuable ED beds.
Hospital-Wide
Flow Capacity (Categories: ED
Throughput, Inpatient Flow)
Bellin Hospital - Bellin Hospital took a hospital-wide approach
to improving patient flow throughout the facility. In doing so, they saw
a dramatic increase in the bed turnover rate.
Improvement Teams (Categories: ED
Throughput)
Shady Grove Adventist Hospital - Three multidiciplinary teams at
Shady Grove Adventist Hospital meet to look for solutions to patient flow
problems throughout the hospital, not just in the ED.
Lean Manufacturing (Categories: ED
Throughput, Patient Satisfaction)
Doctors Hospital - A "lean manufacturing" process helped
Doctors Hospital improve patient throughput by eliminating unnecessary steps
in the patient care process.
Maintaining
Efficient Throughput (Categories: ED
Throughput)
Wilson Memorial Hospital - Wilson Memorial Hospital actively took
steps to maintain its fast throughput times and low left without being seen
rates.
Mobile
Clinical Decision Unit (Categories: ED
Throughput)
John Muir Medical Center - In response to patient flow problems
resulting from increasing boarding in the ED, John Muir Medical Center opened
a Clinical Decision Unit (CDU).
Moving
Patients in 30 Minutes (Categories: ED
Throughput, Inpatient Flow)
Mount Sinai Hospital - Staff wanted to improve the time it took
for a patient to begin treatment to 30 minutes and created the '30 Minute
ER Promise.' It guarantees that a patient will be placed in an exam room
or begin to receive treatment, such as pain medication, x-ray, or lab tests,
within 30 minutes of arrival at the hospital.
New
Ways of Working Program (Categories: ED
Throughput)
Doctors Community Hospital - The American Hospital Association and
Doctors Community Hospital teamed up under a program called "New Ways
of Working" to improve its ED throughput.
No-Wait Emergency Department (Categories: ED
Throughput)
Adventist GlenOaks Hospital - After several years of improvements,
Adventist GlenOaks Hospital was able to completely eliminate waiting in its
ED.
No Waiting Room (Categories: ED
Throughput,
Patient Satisfaction)
Ball Memorial Hospital - Ball Memorial Hospital re-built its ED with
no waiting room.
Online Wait Times (Categories: ED
Throughput, Other ED)
Scottsdale Healthcare - Scottsdale Healthcare posts waiting times
online to let patients know how long they can expect to wait after arriving
at the ED.
Patient
Flow Coordinator (Categories: ED
Throughput, Inpatient
Flow, Patient Satisfaction)
Albert Einstein Medical Center - Long delays in the ED prompted Albert
Eistein Medical Center to create a Patient Flow Coordinator.
Patient
Flow Excellence & Accountability Team (Categories: ED
Throughput, Other ED, Inpatient
Flow)
Mary Washington Hospital - A Patient Flow Excellence & Accountability
Team helped Mary Washington Hospital make process changes in order to meet
requirements to maintain its status as an accredited institution.
Phone Consults (Categories: ED
Throughput)
Johns Hopkins Bayview Medical Center - Admitted ED patients at Johns
Hopkins Bayview Medical Center often waited hours to be transferred out of
the ED and into an inpatient unit. This was addressed with a new procedure
called the Phone Consult.
Public
Education and Remote Monitoring (Categories: ED
Throughput, Other ED)
Lenoir Memorial Hospital - Lenoir Memorial Hospital began an aggressive
advertising campaign to encourage individuals to visit their primary care physician
for minor illnesses and injuries rather than the ED.
Quick Fix Team (Categories: ED
Throughput)
John Muir Medical Center - The Quick Fix Committee meets monthly
to identify needs and problems, brainstorm solutions, and implement and monitor
the resulting changes in the ED.
Rapid Evaluation
Unit (Categories: ED
Throughput, Other ED)
Potomac Hospital - An enhanced triage with a rapid medical evaluation
allows patients at Potomac Hospital to begin receiving care sooner than with
a traditional triage system, which has helped reduce the hospital's LWBS
rate.
Six Initiatives (Categories: ED
Throughput, Other ED)
Lutheran Medical Center - Lutheran Medical Center implemented six
initiatives relating to patient flow and experience in the ED.
Surgery Smoothing (Categories: ED
Throughput)
Boston Medical Center - To address the problem of moving inpatient
admissions for quickly, Boston Medical Center worked on smoothing the surgery
schedule. Elective surgeries were scheduled more evenly throughout the week,
with surgeons only booking the operating room when a surgery was scheduled,
rather than for large, fixed blocks of time each week.
Triage
Treat and Release (Categories: ED
Throughput, ED Treatment Path)
Lutheran Medical Center - Lutheran Medical Center created a Triage
Treat and Release unit to care for lower-acuity patients with 25 protocol
diagnoses in a designated area. This helped decrease congestion in the main
ED area.







