Executives Examine Emergency Department Viability

John Commins, August 15, 2013

According to our May Intelligence Report, while 84% of healthcare leaders expect their ED patient volume to increase within the next three years, at least six in 10 expect their ED's operating margins and reimbursement rates to decline during that period.

What is your organization doing to improve ED performance and ensure the ED's operational viability?

Tim Maurice
UC Davis Health System
Sacramento, Calif.

On the ED and community need: Our emergency department is very important to the community. We are the only level 1 trauma center for inland Northern California, representing an area from the Oregon border to Bakersfield, Calif.

On getting Lean and changing processes: We have been engaging quite extensively in Lean Six Sigma process improvement in the emergency services area to improve the patient experience and throughput throughout the facility. We have put a physician in the triage area so they can perform the screening exam and test the patients while they are waiting to be seen. We implemented a nurse navigator process to have the nurses work with the physician teams to navigate patients through the emergency services area.

On building new protocols: We have been involved in a number of research projects regarding appropriate use of emergency services for patients with head traumas, patients that may have bacterial infection or a meningitis risk. We are really on the cutting edge in identifying protocols that can be used effectively to determine the right level of care for patients to reduce the risk of excess radiation exposure.

On the changing role of the ED: With the Affordable Care Act, I don't expect to see a big increase in the emergency usage. I do expect that over time we are going to use varying levels of care in the emergency department. We feel emergency services are a viable resource not just for the real severe emergencies but also for other levels of care that can be provided within the triage capability of the team.

John Commins

John Commins is a senior editor at HealthLeaders Media.


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