The Emergency Department (E.D.) process is critical for any hospital. On average, approximately 5-10% of a hospital’s total revenue can be attributed to the Emergency Department. And, indirectly the hospital’s Emergency Department accounts for approximately 40-50% of a hospital’s total revenue when considering admissions, laboratory tests, and radiology and other departmental procedures. Frequently, the Emergency Department is a patient’s first experience with a hospital. Short wait times and a positive experience represent important drivers of patient satisfaction. Meanwhile, inefficient processes can result in lost revenues, higher costs and poor community image, not to mention concern over patient safety. Thus improving the E.D.’s patient throughput efficiencies is paramount to both customer satisfaction and a hospital’s bottom line.
Patient throughput time impacts a number of critical differentiators:
• Impacts Quality of Care as long wait times correlate to negative outcomes as well as increase the potential of patients leaving without being seen.
• Impacts Economics of Hospital as patients leaving without being seen is lost revenue, problems with throughput times create overcrowding which could result in patient diversions, and profitability is impacted by service value.
• Impacts External Customers as longer throughput times result in dissatisfaction of patients and families. Satisfied patients become loyal customers who will return for future services AND who will refer friends and family members. Patient satisfaction and loyalty are driven by service value.
• Impacts Internal Customers as service quality is unsustainable without staff satisfaction. Staff retention and productivity is driven by staff satisfaction.
Service value is high when outcomes are excellent and service is caring, safe, complaint and timely. The Emergency Department (E.D.) is the hospital’s front door – making it essential to implement performance management best practices. The current economic conditions are further impacting emergency departments as more and more people lack health insurance or are on government assisted programs and turn to the E.D. as their only source of care.
The increasing demand for E.D. services may result in:
• Long wait times
• Crowded treatment rooms
• Patient boarding in hallways
• Diverted nursing care
• Variable outcomes
• Decreased satisfaction for patients, physicians and staff
The challenge for executives is how to realize and then sustain high levels of performance of an increasingly complex operation without jeopardizing quality, safety and increasing costs. Transformation coupled with performance management provides the framework for a hospital to address these challenges and improve the hospital culture, improve operations, build stronger staff skills, and create visible leadership.
Several things must occur in order to transform your E.D. into the highest quality, most efficient, and patient-centered in the geographic area. They include:
1. Implementing a set of balanced metrics, set goals, and link actions to results through these metrics:
Access: Left Without Being Seen (LWBS); Length of Stay (LOS)
Service: Satisfaction (patient, physician, and employee)
Clinical Quality: Outcomes, deviations, complications; Nursing Turnover; Safety incidents
Value: Expenses per patient day; Charge per case; Pathway variance
2. Changing the operating paradigm
Monitor leading indicators of adverse trends
Show demonstrated improvement in metrics; Launch corrective actions to remove barriers
Perfect performance through continuous improvement
Begin internalization of culture needed to “hold the gains”
Treat this as transformational rather than incremental change
3. Aligning metrics, processes and organizational roles and responsibilities
Ensure process goals and metrics reflect top-level goals and metrics
Align individual responsibilities with key metrics
Provide near real-time information that supports drill-down analyses and automates corrective efforts
Greater Yield can help create a success story that spurs adoption of a new operating paradigm with excellent governance, well-trained, fully compliant staff, a well-resourced, capable E.D. and an environment that focuses on performance and continuous improvement/adaptation. We can help deploy a variety of tools to transform your Emergency Department into the highest quality, most efficient, and patient-centered in the area. We drive reduction in door-to-physician, door-to-discharge, and door-to-inpatient cycle times, while simultaneously improving patient and staff satisfaction. Let us work directly with you to design an approach unique to your E.D. intended to resolve your challenges and yield greater success while expediting the time necessary to complete it.