Optimizing ED operational performance at FirstHealth Moore Regional Hospital

Assessment 

Our consultants conducted a comprehensive assessment of FirstHealth Moore Regional Hospital’s ED processes and performance metrics. The review was based on data analytics and included staff interviews, team shadowing, and patient flow. Several areas for performance improvement were identified for arrival and reception, triage practice and execution, direct bedding, EMS bedding, split-flow model, and leadership development. FirstHealth Moore Regional requested a second consultant to lead a performance improvement engagement.   

Interim ED Leadership

As Interim ED Clinical Manager, the consultant’s first priority was to help bring the EPIC EMR project to completion and concurrently address performance improvement initiatives. The consultant worked together with the ED staff and leadership to review the results of the initial assessment, discussed existing processes and performance metrics, and prioritized those areas of improvement likely to provide the best ROI. A draft plan for implementation began to develop.

Improved ED Performance 

A Performance Improvement (PI) consultant joined the team for a 20-week engagement to identify the gaps between the current and ideal state and confirm the project plan would improve specific and overall ED performance as well as the patient experience. The team agreed to create, implement, and standardize processes, remove all inconsistencies, define roles, assign accountability, and establish new communication practices.

Guided by the PI consultant, the ED team focused its efforts in the following areas:

• ESI Triage Training 
• Front-end process optimization 
• Split-Flow Vertical Care 
• Leadership Development 

Throughout the entire process, the team engaged the broader ED staff. Everyone was aware of the progress and all data was transparent. In this fashion, performance improvement success was wholly embraced by FirstHealth Moore Regional Hospital and positioned them for long-term sustainability. 

Results*

The FirstHealth Moore Regional Hospital team was pleased with the impact the Philips consultants had on their ED performance and requested an extension of the PI project. As a result of the engagement, FirstHealth Moore Regional Hospital was able to sustain improved ED operational performance and an enhanced patient experience, including the below results:

• 83.6% reduction in left without being seen (LWBS), 6.46% to 1.06%
• 62.0% reduction in arrival-to-triage, 13 to 5 minutes 
• 87.0% reduction in arrival-to-room, 31 to 4 minutes 
• 64.0% reduction in arrival-to-provider, 47 to 17 minutes 
• 169% improvement in direct bedding, 24.3% to 65.3%
• Improved patient experience, overall rating of ER care by 95%