News from the 2012 National Client Conference – Transformation to Excellence: A Model for Patient-centered Care in the Emergency Department

While the 24-bed emergency department at Allen Memorial Hospital had a solid reputation, its waiting room had become a patient room for many of the 35,500 visits it had each year, according to Tami W. Jones, director of emergency services and critical care. Non-acute patients routinely waited up to six hours just to be seen.

“Press Ganey saw a good ED, but not an efficient one,” she said. “We needed to move from a staff-centric to a patient-centric triage process."

Working with Press Ganey’s Sandy Myerson, a clinical consultant, Jones and Christopher Hill, DO, medical director, began in 2011 to use an adaptive design methodology to observe, learn and solve problems with the hands-on staff. They also closely analyzed data, using it to drive their decisions. By clearly specifying the role of everyone in the department and charting patient flow, they ultimately eliminated the existing formal and cumbersome triage process in favor of immediate bedding whenever possible. ED staff also transported patients to inpatient units to eliminate delays.

“We had to own our part of the process,” said Hill. “It wasn’t the most popular thing, but it’s what the patients wanted. That’s our rationale to the doctors on the floor and to the hospital board.”

A one-room, four-bed rapid treatment center dedicated to non-acute patients cut wait times to less than two hours and led to an increase in market share.

“Our numbers have picked up – we’re very busy,” said Jones, “but our waiting room is often empty.”