ED Safety Initiative Scrutinizes Quality of Care

There is room for improvement in the nation's emergency departments, where 10 percent of all ambulatory care in the U.S is administered. The Premier Healthcare Alliance has announced a plan to identify where and how improvements can be made. 

A two-year collaborative between Premier and emergency departments at 14 hospitals aims to reduce clinical practice variation, improve care quality, increase patient satisfaction, and improve patient outcomes.

The Emergency Department Safety Initiative focuses on improving patient care and satisfaction in the ED through consistent, accurate and timely diagnosis and treatment of high-risk ED patients.  Topics covered include best practices in the ED, and promoting effective teamwork and communication in the ED.

Premier teams have made on-site assessments at each hospital, said Dan Fineran, assistant vice president of operations and quality at Premier in an interview. "We are looking at all aspects of the emergency department and speaking with physicians, nurses, and patients to get an idea of how the ED operates in a particular hospital.”

The primary focus is to identify areas where there might be room for improvement, provide follow-up support, and to communicate best practices to each participating ED. Among the targets is to improve patient safety metrics to the 90^th percentile.

The 14 participating hospitals represent more than 730,000 annual ED visits. The EDSI will initially target patients presenting in EDs with chest and abdominal pain, two of the most difficult and nonspecific diagnoses. These conditions are most commonly associated with more severe outcomes such as heart attacks, appendicitis, meningitis, and pancreatitis.

According to the Agency for Healthcare Research and Quality, abdominal pain is the fourth highest principal reason for all ED visits in the country, with 4.6 million visits in 2007. Nonspecific chest pain is the fifth highest principal reason for all ED visits in the country, with 3.8 million visits in 2007.

The collaborative will look at avoidable and unplanned ED readmissions to help understand the components and outcomes related to patient flow. Fineran explained that when looking at chest pain patients “we’ll work with the ED to identify the process for treatment, especially the time it takes for these patients to get from door to doctor and door to EKG.” Problem areas and their impact will be identified and then the ED will decide what improvements it wants to make to eliminate those problems.

•         Eisenhower Medical Center; Rancho Mirage, Calif.
•        Kuakini Medical Center; Honolulu, Hawaii
• ·        Methodist Medical Center of Illinois; Peoria, Ill.
• ·        Baptist Hospital East; Louisville, Ky.
• ·        Baptist Hospital Northeast; LaGrange, Ky.
• ·        Baptist Regional Medical Center; Corbin, Ky.
• ·        Central Baptist Hospital; Lexington, Ky.
• ·        Western Baptist Hospital; Paducah, Ky.
• ·        Baystate Medical Center; Springfield, Mass.
• ·        Fairview Southdale Hospital; Edina, Minn.
• ·        Presbyterian Hospital; Albuquerque, N.M.
• ·        Summa Akron City Hospital; Akron, Ohio
• ·        Johnson City Medical Center; Johnson City, Tenn.
• ·        Texas Health Presbyterian Hospital of Dallas; Dallas, Texas

Because the participating hospitals are located in nine states, Web conferences and e-mail alerts will be regularly presented to the group by emergency department and risk management experts addressing ED-specific patient safety topics.