Case Studies
Emergency Service Partners has the privilege of partnering with top-quality healthcare institutions that are dedicated to excellence within the Emergency Department. These case studies are the result of joint efforts between hospital administration, nursing, staff, and Emergency Service Partners.
Case Study #1
Customer Service
Case Study #2
Customer Service
Case Study #3
Customer Service
Case Study #4
ED High Alert Program
Case Study #5
Virtual ED/Emergency Physician in Triage
In the first three case studies, our collaborative efforts identified three areas that directly relate to customer service within the Emergency Department. These include Left Without Being Seen (LWBS), Turn Around Time (TAT) and Patient Satisfaction Survey Results (Provided by Press Ganey at the three case study hospitals). Case Studies 4 and 5 demonstrate how ESP developed programs to manage unnecessary Emergency Department visits and overcrowding.
ESP Case Study #5: Virtual ED/Emergency Physician in Triage
EMERGENCY DEPARTMENT SETTING:
- Regional trauma center in large city
- 45 bed Emergency Department
- 80,000 annual visits
KEY CONCEPTS:
- Move initial physician evaluation “forward”
- Rapid initiation of diagnostics
- Patients see physician earlier in visit
- Create “virtual ED beds” with fast turn-over
- Quick and simple disposition of very minor patients, reserve valuable bed space
- Second initial assessment, early in visit, to back-up triage nurse and reduce triage error
PROCESS:
- Patient presents at front desk
- Two nurses provide “quick look” triage
- If a true emergent condition is identified, patient is immediately taken to appropriate treatment area (usually critical medicine/trauma)
- Otherwise, clerk simultaneously takes minimal information to match medical record number or create new number, and enter patient into tracking system
- Patient is then fully assessed and triaged
- Majority of patients then go to the virtual ED composed of two beds and staffed by an ED physician and nurse
- Level 3 patients typically have work started, i.e. lab, x-ray, CT and are then sent to the main Emergency Department for further treatment and disposition
- Level 4 & 5 patients may be quickly treated and discharged from Virtual ED, or can go to Fast Track for minor procedures, etc
- Allows ED Physicians and Fast Track Nurse Practitioners to pick up patients that are already in process and ready for further treatment and disposition
- When the main Emergency Department or Fast Track are at capacity, patients may return to waiting room until treatment space is available; however, work-up is in progress
RESULTS:
- Reduced patients who leave without being treated (LWBS) – cut by over 50%
- No additional ED staff resources required – some of the work load starting diagnostic work-ups shifted to virtual ED, and staff shifted with that work load
- Reduced triage error, especially under triage resulting in ill patients in waiting room
- Reduced congestion in main Emergency Department, with minor patients never moving past Virtual ED
- Extremely valuable during peak volumes and high occupancy
- Docs in virtual ED rotates shift equally with other ED docs and are paid an hourly rate
