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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.



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