Enhancing the front lines of emergency care through analytics

Interfacing with nearly every department in the health system and the ‘front door’ of most hospitals - the emergency department (ED) serves an important purpose for many patient’s overall healthcare journey. Nearly 142 million patients visited an ED in 2014¹, with 90.8% of them only experiencing the ED as admission was not required.
 

But not every emergency department is the same. Hospitals vary widely in their service offerings, technology strategy, patient experience, and more to best meet the needs of their unique populations. In response to increased volume and issues with throughput, many health systems are enhancing their EDs for optimal performance through a renewed strategic approach in which data is leveraged in a manner that increases both technology utilization and staff efficiency.
 

Emergency departments have begun to recognize the power of performance analytics and transparency into the operation they can provide. McLeod Health Clarendon Hospital (MHCH) in Manning, South Carolina was a newly acquired hospital in the McLeod Health System and the ED began experiencing a steady increase in volume, signaling the need for throughput and performance improvements.

Assessing needs

With ED overhauls on the horizon, MHCH enlisted the help of Philips Blue Jay Consulting to jumpstart the efforts. Philips was asked to help improve ED front-end operations and patient throughput as well as create a culture of accountability for ED staff. To kick off the collaboration, the team started by conducting a comprehensive assessment of the ED which included a comprehensive data analytics review, numerous on-site observations, and staff and leadership interviews. The assessment revealed a number of inefficiencies and education gaps which negatively impacted the department’s overall operations.
 

To ensure the process changes in development would be able to fully support these necessary improvements, a Philips TransformAnalytics Performance Dashboard was recommended to serve as an essential component in highlighting performance issues, monitoring the impact of changes made and helping MHCH achieve its operational goals.
 

Change initiatives

With these goals in mind, MHCH and Philips began a 13-week performance improvement engagement focused on the identification and implementation of new processes for the ED and its staff. The program focus included the following:  
 

• Revision of triage processes
• Implementation of split-flow processes
• Establishment of new patient experience standards
• Enhanced charge nurse role
• Revised performance expectations
• Implementation of novice nurse training
   

These change initiatives would be consistently monitored via the performance metrics built into the new ED dashboard. Through the use of the dashboard, the Philips consultants were able to drill down on the root causes of throughput issues, analyzing factors by the month, day – even by the hour – as well as by the physician and by patient demographics. As the process changes were implemented, the dashboard metrics were used to measure impact and delineate which new processes were most successful and which processes needed additional change to reach the highest potential.
 

Education and training

Philips provided dashboard training to MHCH’s active users, to demonstrate how they are able to drill-down to the root-causes of performance issues, as well as maintenance support and ongoing consulting guidance. The dashboard is updated from MHCH’s system data daily via automatic uploads from multiple sources to maintain ongoing transparency of the department’s performance and help reliably sustain improvements.
 

Enhanced visibility

The impact of the TransformAnalytics Performance Dashboard was not limited exclusively to the analytics and performance improvement teams. The dashboard also sent performance snapshots via automated daily emails to stakeholders including MHCH’s hospital C-suite, medical directors, and nursing leadership within the ED. The emails provide the most relevant information to each person, based on their role. This level of visibility ensured all key stakeholders had direct access to the performance trends so they would have the information they needed in a single dashboard view.
 

Philips consultants also recommended education initiatives including educating staff on the 5-level Emergency Severity Index (ESI) triage system including inter-rater reliability, ED patient experience standards, and a customized novice nurse curriculum. The education programs were well-received by staff and leadership alike.

By the numbers

As a result of these collaborative and patient-focused engagements, Philips was able to help MHCH significantly improve its performance metrics*, including:

• Reduced arrival-to-triage by 87.5% (12 to 1.5 mins)
• Reduced arrival-to-provider by 51.5% (33 to 16 mins)
• Reduced LWBS (Left Without Being Seen) by 65% (4% to 1.4%) which generated $567,000+ in additional annual collectable revenue

Through the implementation of these new operational processes and the TransformAnalytics Performance Dashboard, Philips helped MHCH achieve the high level of performance improvement they had aspired to reach. The collaborative and data-based approach has provided the MHCH team with the methods, tools, and increased commitment to continue the efforts for long-term success.