Applying SHS Conference Learnings Back at the Ranch

Session
Emergency Services / Patient Throughput

Author
Julian Jollon
Manager
Resource Optimization & Innovation
Providence Health & Services

Description
Based upon 2007 SHS proceedings on ED patient throughput, our ED improved patient flow dramatically. After reviewing the presentation papers, we quickly designed our Lean-based Advanced Treatment Area. Within 2 months, radical decreases in patient visit LOS, LWBS rates, and Door-Doc times were realized.

Abstract
Previous ED throughput presentations given at SHS focused on the implementation of ED workflow using "qTrack" at Ochsner Health System. After attending a number of these sessions, our team brought back to Providence the methodologies and papers for closer examination. Realizing that these efforts could be successfully implemented at home, it was full steam ahead. Get out of the way! After initial team selections we dove directly into analyzing our current facility layout and patient process flows. Once we had determined what these looked like, we studied the SHS presentation papers to guide us with our customized design. Gemba walks facilitated with the future state layout designs. Data analysis determined the scope of services needed for Level IV and V patients. A new unit was then designed and created based on our findings. Schedules were modified to dedicate staff to the ATA unit. Due to the construction of the new unit, processes within the ED changed and had to be tailored to the new workflow. A six-week trial was completed and the results were astonishing. LWBS rate went from an average of 12.3% to 2.6%; Door-Doc time: 113 minutes to 46 minutes; and LOS: 162 minutes to 98 minutes.