ED management : the monthly update on emergency department management
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With a poor safety record and long waits for care, the ED at St. Vincent's Medical Center in Bridgeport, CT, launched a comprehensive improvement effort that has slashed door-to-doctor times, drastically improved patient satisfaction, and reduced serious safety events to zero during the past year. Key to the approach is a team-based operations system that makes care teams responsible for specific zones in the ED. ⋯ Door-to-doctor times have been reduced from 126 minutes to less than 25 minutes. Team approach to care improves clinician satisfaction while reducing errors. A streamlined triage system has eliminated several steps for low-acuity patients.
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Under the final rules for Medicare's value-based purchasing program, one-third of the funding that is set aside to reward quality will be based on how patients rate their hospital experience. However, some EDs are already working to maximize patient satisfaction by implementing programs or policies whereby patients who have been discharged are routinely called to make sure their recovery is going well, as well as to intervene if there is an opportunity for service recovery. ⋯ To avoid pushback among staff, consider beginning a program of patient callbacks by asking clinicians to call back just two patients per shift worked, and to share their experiences with colleagues. For maximum value, experts recommend that patient callbacks be made within one to four days of discharge.