ED management : the monthly update on emergency department management
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Emergency department administrators at Cambridge Health Alliance, a three-hospital health care organization in Cambridge, MA, implemented a system-wide flow initiative that has reduced the average length-of-stay for rapid assessment patients from three hours to just over an hour. Under the approach, patients are immediately placed in a room, and providers and registration staff come to the patients rather than the traditional approach of having patients constantly move from place to place with wait times in between each interval of care. ⋯ The leave-without-being-seen (LWBS) rate has been slashed from 4.5% to 0.6%. System-wide ED volume, which was dropping before the new approach was implemented, has gone from 77,000 patients per year to nearly 100,000 patients per year.
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Christiana Hospital in Newark, DE, has been able to dramatically reduce length-of-stay in the ED by making use of data derived from a real-time location system (RTLS) that tracks the movements of patients, providers, and staff. Administrators say that while some efficiencies are gained from the system alone, most of the positive impact is derived from using the RTLS data to focus on specific processes and make refinements. ⋯ Similarly, a work group focused on the ESI 3 population reduced the average treatment time for this population from 5 or 6 hours to 3.4 hours. Administrators say key steps toward a successful RTLS implementation are careful planning for how you want to use the technology, and alleviating staff concerns about why their movements are being tracked.