Enhancing Performance Excellence: Total Emergency Services Redesign

Session
Emergency Services

Authors
Sharon Hickman
Senior Performance Engineer
Premier, Inc.

Jill Russell
Admin Director Emergency Services
Bon Secours Memorial Regional Medical Center

Description
MRMC formed a Multi-disciplinary team led by the ED director and Management Engineering to address long wait times, walk-outs, patient dissatisfaction, diversion, lost revenue, and eroding market share. Six sigma and process simulation were used. The session will cover how successes were achieved and future goals, including a 0-1-2 concept.

Abstract
Bon Secours Memorial Regional Medical Centers Emergency Department was given the charge to redesign workflow and patient care to meet a 30 minute Emergency Care guarantee. An ED Functional Redesign Team was developed to address long wait times (1-8 hours), which results in walk-outs, patient dissatisfaction, hours on diversion, lost revenue and an eroding market share. To support this project, a Six Sigma team was used to identify areas of opportunity for overall ED redesign. The team developed a dashboard to track their progress and has show great success: Overall length of stay: 36% decrease (247 minutes to 158) ALOS for discharged patients: 42% decrease (241 minutes to 141) ALOS for admitted patients: 28% decrease (432 minutes to 310). Door to treatment space: 94% decrease (70 minutes to 4) Door to provider: 82% decrease (79 minutes to 14) Controllable diversion hours: 100% decrease (54.5 hours to 0) Walkouts: decrease from 3.44% to 0.03% Patient satisfaction percent excellence responses: increase from 33% to 96% Staff Engagement Scores (Gallup): 75th percentile The team is moving forward with a goal to have patients discharged within 60 minutes or admitted to the units within 2 hours. Simulation has provided guidance on the next steps to improve patient throughput and moving patients out of the ED in a timely matter. The session will discuss where the hospital started, how successes were achieved, and how the hospital is planning to achieve future goals, including the formation of a patient flow team to address LOS for admitted patients.