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
Case Study #6
ESP Scribe Program
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, 5 and 6 demonstrate how ESP developed programs to manage unnecessary Emergency Department visits, ease overcrowding and the utilization of scribes.
Case Study #6: ESP Scribe Program
EMERGENCY DEPARTMENT SETTING:
- Trauma Center/Tertiary Care Hospital for multiple county area
- 60,000 visit Emergency Department
- 28 Emergency Department beds
CHALLENGE:
- Increase physician productivity (ACEP estimate of 90-120 minutes of an 8-hour emergency physician shift is spent on documentation)1
- Increase physician staff satisfaction/retention
- Free physician to focus on patient care rather than documentation
EFFORTS:
- Designated ESP emergency physician as ESP Scribe Program Coordinator
- Program Coordinator developed relationship with area university to develop "prospective scribe pool"
- Efforts focused on pre-med, dental, PA, nursing students, etc. off for semester or year
- Developed scribe credentialing process with hospital:
- ESP Scribe Program Coordinator personally interviewed candidates
- Performed background checks
- Developed scribe rules and conduct for review and signature
- Medical terminology exam
- Obtained ED/Hospital IS access for approved scribes via Hospital
- Hospital provided HIPPA video for all scribes to review
- Hands-on training
- Trained ESP emergency physicians on scribe utilization:
- Strict rules of "scribes dos and don'ts"
- Physician verbal cues and citing of history, physical exam findings, and other data to scribe
RESULTS:
- An increase in emergency physician productivity of 17.3% in the Main ED (exclusive of minor patients seen in a separate express care/fast track)
- Physician shifts with scribe decreased Turn Around Times 20 minutes per patient while at the same time ED volume increased and hit hospital record highs
- Significant decrease in LWBS
- Backdated charts decreased by 95%
- Positive individual patient comments and increase in overall patient satisfaction scores
- Increased physician satisfaction
1 ACEP Task Force Report on Boarding, "Emergency Department Crowding: High-Impact Solutions", April 2008.