Retrospective Analysis of Quality Improvement Throughput Measures at a High‐Volume Community Emergency Department. Issue 5 (3rd June 2013)

• Record Type: Journal Article
• Authors: Milsten, Andrew; Klein, Joel; Liu, Qin; Vibhakar, Neel; Linder, Lawrence
• Is Part Of: Journal for healthcare quality. Volume 36:Issue 5(2014:Sep./Oct.)
• Page Start: 13
• Page End: 25
• Publication Date: 2013-06-03
• Subjects: Medical care -- Quality control -- Periodicals; Quality assurance -- Periodicals; 362.1
• DOI: 10.1111/jhq.12014
• Languages: English
• ISSNs: 1062-2551

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jhq12014-sec-0010" sec-type="section"> <title>Objective</title> <p>To assess the effect of having a physician or physician's assistant (PA) as patients' first point of contact in our emergency department (ED) on the rate of leaving without being seen (LWBS) and wait time.</p> </sec> <sec id="jhq12014-sec-0020" sec-type="section"> <title>Methods</title> <p>In before and after intervention conducted in the ED at a 265‐bed community hospital, data were collected on all patients presenting to the ED during a 70‐month period. A physician or PA was stationed in triage 16 hr a day. The screening process included measurement of vital signs, a brief history and physical examination, and computerized physician order entry.</p> </sec> <sec id="jhq12014-sec-0030" sec-type="section"> <title>Results</title> <p>During the study period, volume increased from 86, 000 to 102, 000 patients per year. Monthly averages for ED visits increased 16%, admissions increased 5%, and ambulance visits increased 18%. The rate of LWBS decreased from 3.1% to 1.7%. Door‐to‐doctor time decreased by 14 min.</p> </sec> <sec id="jhq12014-sec-0040" sec-type="section"> <title>Conclusions</title> <p>Despite an increase in patient census, the LWBS rate and door‐to‐doctor time decreased. This study of one solution to the issue of ED crowding demonstrates how a process redesign can lead to successful changes in throughput metrics.</p> </sec> </abstract>