You want the leaders at your organization to pay attention to ED throughput and intervene when the wait for a bed gets too long? Put the data on their smartphones. I was in Atlanta recently for a roundtable discussion for our most recent Breakthroughs report, The Coordinated ED. Over the course of the event, it seemed like two of the ED leaders there checked their mobile devices—and the nifty little app that lets them monitor patient population data—at least one million times.
During a phone interview, Leon L. Haley Jr., MD, deputy senior vice president of medical affairs and chief of emergency medicine for Grady Health System pulled out his smartphone and clicked a few keys. "We have two admissions that are waiting for a bed and both of them have a bed," he told me. "They just haven't gone upstairs yet. There are 115 patients in the ED right now that are active, only two of which are admissions."
At Cambridge Health Alliance, which is also featured in the report, leaders have on-site and remote access to ED data via their smart phones, as well. And if the numbers start to stray too high, every administrator gets a page and is expected to pitch in to help solve the problem. They call it "Code Help."
CHA also posts wait times on the organization's web site. The numbers refresh every 10 minutes as the patient population ebbs and flows. Rarely does the posted wait time at the Cambridge location, the busiest of the system's three EDs, break the five-minute mark. Wait times at the other two campuses are routinely just two or three minutes.
That helps community perception of the three EDs which, in turn, builds market share.
3. Send physicians alerts
Cambridge uses an automated program to alert primary care physicians by email and by text whenever one of their patients arrive in the ED. The physicians love the program. Before it was implemented they would often complain that they had no way of knowing their patient had been treated unless he or she was admitted. It's embarrassing, docs said, to have a patient come into the office to talk about an ED visit the doc didn't even know about it.
"It is not unusual for the physician to call and discuss the case," says Assaad Sayah, MD, chief of emergency medicine at CHA. "This is one way we've been able to coordinate care."