As for patient experience, that is a tough nut to crack for an organization, especially in the ED, where it is noisy, busy, and many patients may see themselves as a top priority. Even in Grady Health System's ED, Atallah says there is a long way to go, but is encourage by a positive trend.
"We started 2014 in the 1st percentile," says Atallah. "But we finished in the 28th percentile, and our goal is to get to the 55th this year. The key thing we've learned is you have to keep making patient experience a priority."
Success key No. 2: Stratify for senior care
One of the newest trends in ED throughput is giving special attention to seniors who present.
ECRI Institute, the nonprofit health research organization based in the Philadelphia suburb of Plymouth Meeting, Pennsylvania, listed geriatric ED units in its 2014 Top Ten Hospital C-Suite Watch List because of the aging baby boomer population.
Grady Health System does not currently have a specialized geriatric ED unit, but Atallah says the idea has caught the emergency department's attention. "We're going to try to implement specialized geriatric treatment rooms in our new ED," says Atallah.
One of the first EDs built specifically for seniors is in Silver Spring, Maryland, at Holy Cross Hospital, a 437-bed nonprofit teaching hospital that is part of Holy Cross Health, which is part of Livonia, Michigan–based Trinity Health.
Blair Eig, MD
The senior emergency room opened in November 2008 after Holy Cross Hospital CEO Kevin Sexton noted that the care his mother had received could have addressed her needs differently.
"She was in her late 80s, and the experiences she had and he had when he visited her were of a big, busy, loud emergency room, like all emergency rooms tend to be," says Blair Eig, MD, chief medical officer for Holy Cross Hospital.
Eig says that at the time, the hospital had a big enough footprint to make space for a seven-bed senior emergency room. He says they moved what was a fast-track urgent care section of the ED up one floor, then reconfigured the space to cater to seniors and their families.
"The changes aren't necessarily complicated, but you've got to think about it in terms of what the seniors need," says Eig. "It's changing the lighting, the paint on the walls, the floor color so it is easier for seniors to navigate."
Eig also says walls were put up between the seven bays to reduce noise. Mattresses are much thicker, and telephones and remote controls have larger numbers so they're easier for senior patients to see. Blanket warmers and space for families were added to the rooms, too.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.