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ED throughput: Reducing walk-out rate by 85.3% at St. Mary Medical Center
Improving ED workflow and performance at a 44-treatment emergency department
When an emergency department’s workflow is inefficient, wait times can increase, care is not always provided in a timely manner and patient and staff satisfaction may suffer. This was the situation at St. Mary Medical Center (SMMC) in Apple Valley, California, in early 2015. The 44-treatment emergency department was receiving approximately 82,800 visits annually and was struggling with a constrained physical plant space, recurring gaps in ED nursing leadership, prolonged ED lengths of stay and high left without being seen rates.*
Results
When St. Mary Medical Center began its engagement with Philips, ESI level-3 patients often found themselves in the ED waiting room, not knowing what the plan was for their care, with no ownership from staff, for a stay that could seem like an eternity. This project helped develop and implement a process that resulted in:
Our assessment methodology
Our recommendations
Revise front-end processes to include the intake and triage processes
Re-educate staff on the ESI 5-level triage system, to include inter-rater reliability and competency validation
Restructure leadership and clarify roles of each member of the ED team, increasing accountability for standards of practice and quality of patient care
Examine utilization of existing space to optimize workflow
Implement standard work processes to address the frequent capacity issues in the ED
Create and agree to a shared vision and mission for the ED leadership team
Customer story
How AMITA Health shifted its culture to deliver value-based care
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*Results are specific to the institution where they were obtained and may not reflect the results achievable at other institutions.
