Ascension Seton Northwest Hospital Decreases Wait Time in Emergency Department

Problem:

In January 2017, leadership at Ascension Seton Northwest realized that it was not optimizing the use of space in its busy emergency department. The department has a total of 20 beds, but 12 were always reserved for patients with less complex needs who only required an exam, while the remaining 8 beds were set aside for acute patients (heart attack, stroke, trauma).  This arrangement often caused a backlog of patients in the waiting room and decreased patient satisfaction.

Intervention:

Leadership decided to make a change after running a table top exercise with their Studer coach.  Under the new plan, all beds would be available to all types of patients. The table top exercise included participation by nursing staff, the emergency department’s medical director, staff physician and ancillary services

Under the new scenario, which is still in place, Patients no longer have to wait until the “right kind” of bed was available. “Our goal was to increase quality of care and patient experience by getting our patients in front of our providers faster,” Cindy McCord RN, BSN, the clinical manager for Ascension Seton Northwest’s emergency department and trauma services.

Results:

The change in space and staff allocation has had a significant impact on several important metrics:

  • Door to provider time decreased from 23 minutes (January 2017) to about 11 minutes (August 2017).
  • Length of stay (door-discharges) dropped from 167 minutes (January 2017) to 149 minutes (Summer 2017) and has been at this rate or lower ever since the change was implemented.

In addition to decreasing patient wait time, the change had a positive impact on staff satisfaction. “Originally there was some pushback since it changed the way the team worked, but once they worked with new model for a while, they began to like it and could see the benefit of getting patients to providers sooner,” said Cindy. “Our night shift is also not seeing as big of a backlog of patients waiting in the lobby when they arrive on duty since the patients are already in the room being seen. So, they are not having to start their shift apologizing for the wait to frustrated patients.”