A Revolution in ED Patient Throughput Management

Session
Emergency Services

Author
Joseph Guarisco
Chairman of the Department of Emergency Medicine
Ochsner Health System

Description
This session will demonstrate workflow solutions to ED crowding by specifically targeting input constraints in a typical capacity management model. In 2005 Hurricane Katrina forced several New Orleans area hospitals to close, some permanently. As a result, one New Orleans ED saw its patient volume increase 50%, significantly impacting operations. Hear how the ED implemented Q-Track to eliminate wasteful barriers to patient care and enabled patients to see a physician faster, which resulted in rapid and dramatic improvement in critical measures of operational performance.

Abstract
Facing with a dramatic increase in volume, this New Orleans ED was challenged with finding an innovative solution to its overcrowding problem. ED leadership designed the qTrack process to create virtual ED capacity and dramatically reduce time-to-physician thereby reducing total patient cycle times. Patients who left without being seen numbers plummeted. This presentation will describe the qTrack process, how it was implemented in a very short timeframe, and detail the positive results it has had on operational performance and patient satisfaction. EDs using qTrack or similar Rapid Medical Evaluation (RME) workflow solutions are able to significantly improve their capacity to accommodate demand without building beds, to virtually eliminate patients who leave without care, even in the most overcrowded departments. The lessons learned and cultural challenges of changing or eliminating wasteful steps in the value stream will also be discussed.