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ED Performance and Viability

John Commins, for HealthLeaders Media, September 13, 2013
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Kyle Martin, MD
Medical Director for the Emergency Department
St. Mary’s Hospital
Madison, Wis.


Kyle Martin, MD


Kyle Martin, MD

We anticipate that our volumes will continue to climb as compensation decreases. We are going to do a deeper dive on managing our costs. One of the pieces we have looked at recently is how we compare to some of our hospital peers. For example, indirect care time for staff is actually quite a bit higher than it is most of our peer hospitals.

Our department has been markedly successful in working our door-to-doc time. When I started as medical director in 2007 our average door-to-doc time was around 45–50 minutes. We have gotten that down to be around 13 or 14 minutes. That really is the core to having a safe ED where patients are getting in front of a provider in a relatively short period of time to make sure they don't need a stabilizing intervention, but also improving how quickly they can move through the ED.

We are looking at how we are staffed and other ways where we could continue to maintain that level of efficiency and that level of care while perhaps relying less on the nursing hours and seeing if there are more tasks that technicians or paramedics could help with.  As we shift toward value and away from volume it is important that you are doing things in as efficient a manner as possible.

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