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4 Ways to Accelerate ED Triage, Boost Revenue

Joe Cantlupe, for HealthLeaders Media, October 13, 2010
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With creation of the asthma lounge, the average wait time for ED patients with asthma attacks fell from 128 minutes in 2006 before the lounge opened, to just 4 minutes, according to the hospital.

 "Before we had such a backlog of patients who were in the emergency department, often because of asthma patients," says Rosemery Williams, manager of pulmonary services for the hospital. Asthma patients "would come in with shortness of breath or chronic lung problems. They often didn't have a primary care doctor, and would use the emergency department as a drop-in clinic" she says.
The new clinic "has significantly reduced wait times and has enabled asthma patients to be treated before a significant emergency," says Williams.

With its ED triage system, the hospital quickly treats asthma patients and provides immediate assistance to those experiencing attacks. The patients needing assistance go to the asthma lounge, which is located within the ED and includes two beds and two lounge chairs and is staffed 24 hours a day. Nurses and respiratory therapists, often using nebulizers, work to relieve the asthma attacks.

An education component is considered important to the program because patients need to "recognize the symptoms of asthma. Some patients who have asthma don't realize they need urgent care," says Brandy Burrows, ACMC's director of respiratory care services.

Under the education plan, patients learn the triggers of an attack and when there is a need to start treatment, and then they begin to establish a sensible relationship with a primary care physician. It improves and speeds up the process, she says. The hospital expects to expand its coverage in the asthma lounge.  "This has been a safety net, and now with the recession more people are coming in, and it's more important than ever," Burrows says.

Success Key No.3: Pharmacists in ED

By having pharmacists in the ED to review high-risk medications prepared for patients, Sarasota (FL) Memorial Hospital has achieved better patient outcomes and reaped substantial savings in pharmaceutical costs, according to Deborah J. Larison, PharmD, CPh, clinical pharmacy specialist
and toxicology/emergency medicine director for the 806-licensed-bed hospital system.

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2 comments on "4 Ways to Accelerate ED Triage, Boost Revenue"


Jeanne McGrayne (10/13/2010 at 12:16 PM)
Could the author please provide a reference for the 4 hour 7 minute average wait time nationwide? This is not consistent with a number of ED benchmarks available. Thank you

John Murphy (10/13/2010 at 10:14 AM)
Most ER's triage patients using an experienced nurse to assess severity. Our clinical advisor, Dr. Donald Thomas, developed a formulaic, computer assisted application for ER triage. The level of severity is assessed using hospital developed measures and the chief complaint invokes diagnostic protocols prior to the patient registration. The typical result is a "one touch" visit by the ER physician usually resulting in reduced throughput by at least an hour. We are looking for early adopters.