Engineering a High-Performance Emergency Department

The list of real challenges to emergency department improvement includes the fact that the ED is open 24 hours a day to treat anything from a scratch to a stroke, requires a multi-disciplinary team of doctors and nurses to work together quickly and efficiently, and for good or bad often represents the patient's impression of the hospital as a whole.

The leadership team at Massachusetts-based Cambridge Health Alliance faced the same challenges as any ED but with a few of its own, including its mission as an urban safety-net provider. Capital for expansion and renovation was limited.

So the team undertook a series of operational and clinical initiatives, including a review of throughput, a new staffing model for ED nurses, and boosting compensation along with accountability for physician performance.

In a new HealthLeaders Media Rounds case study, Create Your High-Performance, Patient-Centered Emergency Department  the physician, nurse and executive leaders dive into specific steps they took to dramatically improve key ED performance metrics, including ambulance diversions, wait times, door-to-admit times and others.

As with any performance turnaround, the specific steps are enabled under a protective cover from leadership, including: