Hospital Leaders Give Strategies to Remove ED Bottlenecks

Such a person "must have the accountability, authority, and frankly, responsibility to make decisions, because if no one makes decisions, we're going to have that bowel obstruction."

Eastman also described a "low-tech" strategy at Scripps Mercy Hospital, where emergency teams now triage patients, and put those who don't need a bed into a reclining chair instead. He said Mercy has "doubled their capacity without adding beds, and taken wait times from five hours to two hours, and reduced the [number of those who] leave without treatment from 8% to 2%."

Jedd Roe, MD, chief of emergency medicine at William Beaumont Hospital, a 1,061-bed facility in Royal Oak, MI, described an experiment that improved patient satisfaction scores at his facility. Beaumont prepared "scripts" in which emergency room staff would explain to patients how long—with much more detailed layers of specificity than is typical—a procedure such as a test, might take and when the results would be ready.

"What I found was that patients realized that now they could plan," Roe said. They might think, "Maybe I have time to run home and feed the dog, or go to the cafeteria, and bring something back for the patient."

Robb White, RN, director of emergency services at Tomball Regional Medical Center in Tomball, TX, a 357-bed facility, stressed the importance of checking the statistics of where patients are in the hospital every day, not where patients were the day before, and publishing it so everyone in the hospital understands the problems.

The next HealthLeaders Media Rounds "Cancer Service Line Success: Better Coordination, Better Outcomes" is scheduled for Tuesday, March 30 at Banner Health.