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ED Performance and Viability

John Commins, for HealthLeaders Media, September 13, 2013
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David M. Zechman, FACHE
President and CEO
Ozarks Medical Center
West Plains, Mo.

We started with improving the physician and nursing documentation chart along with audit reviews, not only by our documentation integrity team, but also by our medical director, Dr. Kathryn Egly. As part of that, hours of one-on-one education have been provided to the ED physician staff and nurses on appropriate documentation to show the true level of care that a patient is receiving.


David M. Zechman


David M. Zechman, FACHE

The second thing we have done is decrease a metric we call the left before exam rate. Five or six years ago our LBE before our new ED opened was anywhere from 5%–7%. In 2012 it was 3.2% and year to date it is 1.2%. We are capturing more patients who were leaving the ED without being seen and we've done that through putting a nurse practitioner in a fast track right at triage.

Finally we have terrific physician leadership in our emergency department. I am a big believer in physician champions with clinical service lines. Under Dr. Egly's leadership has we are creating new mechanisms for efficiency as well as measuring quality and holding the physicians accountable for quality and patient satisfaction.

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