Monday, April 2, 2012

What are the important things to measure for ED flow improvement?



There are many metrics in the ED, ranging from patient satisfaction to % of Medicaid patients.   To improve patient flow and identify bottlenecks, there are 10 steps and times that should be measured:

1. Door to Triage
2. Triage to MD (assuming MD is in triage)
3. Bed to RN
4. Bed to MD
5. MD to Decision (DC vs. ADMIT)
   6) Imaging order to read
   7) Lab order to results
   8) Recheck of patient
9) DC to actually being out of ED
10) ADMIT to floor

If you add the total time of each of these steps, this equals total Length of Stay in ED (LOS).

Based upon the review of the time needed for each of step, an ED director can determine which areas need more effort and time to reduce the time in ED.  This is crucial because patient satisfaction is linked to the overall time in ED. 

2 comments:

Code3Spots said...

This goes to show how important it is to have an experienced triage nurse and docs that can dispo patients quickly.

Jackie Champion said...

Hey there! Thank you for posting this information about emergency care. You have such an very interesting and informative page. I am looking forward to visit your page again and for your other posts as well. Keep it up! I'm so glad to pass by your page and to have additional knowledge about emergency care.
Well, I'd like to add that I have read in one article that emergency medicine encompasses a large amount of general medicine and surgery including the surgical sub-specialties. Emergency physicians are tasked with seeing a large number of patients, treating their illnesses and arranging for disposition—either admitting them to the hospital or releasing them after treatment as necessary. The emergency physician requires a broad field of knowledge and advanced procedural skills often including surgical procedures, trauma resuscitation, advanced cardiac life support and advanced airway management. Emergency physicians must have the skills of many specialists—the ability to resuscitate a patient (critical care medicine), manage a difficult airway (anesthesia), suture a complex laceration (plastic surgery), reduce (set) a fractured bone or dislocated joint (orthopedic surgery), treat a heart attack (cardiology), work-up a pregnant patient with vaginal bleeding (Obstetrics and Gynecology), stop a bad nosebleed (ENT), place a chest tube (cardiothoracic surgery), and to conduct and interpret x-rays and ultrasounds (radiology).
Emergency medical pros with a combined 40+ years of experience all in one pace.

Emergency Care Kingston