WINSTON-SALEM, N.C. – The Emergency Department of Wake Forest University Baptist Medical Center has won a Thomson Reuters 2009 Healthcare Advantage Award for performance efficiency by improving patient throughput by decreasing the length-of-stay time and the number of patients who left without being seen by a physician.
The awards were recently presented in San Diego at the 2009 Healthcare Advantage Conference, the annual gathering of Thomson Reuters Healthcare customers. The awards, in categories such as strategy and growth, health and clinical outcomes, and consumer outreach and communications, honor hospitals and health care payers that use data analytics to improve business results and the quality of care.
“Patient volume in the ED is an ongoing challenge for us, but we’ve made a lot of gains and improvements. The ED team continues to seek solutions to help us provide the best care possible,” said James Bryant, R.N., M.S.N., director of Emergency and Transport Services.
Over the past five years, the Emergency Department (ED) has experienced a 50 percent increase in the number of patient visits with limited additions to staff and space. As a result, the ED was no longer able to exceed national benchmarks for key measures in length of stay, care of pneumonia, and stroke and heart attack patients.
The ED employed ACTION O-I Performance Improvement Solution, a database that provided comparative benchmarks and data to help identify key areas for performance improvement. Patient flow was reconfigured from arrival through discharge based on Six Sigma methodology and other staff-driven initiatives. As a result, length-of-stay and patient walkouts were both reduced by more than half. Performance indicators for pneumonia and stroke and heart attack now meet or exceed national benchmarks. The ED staff and physicians work to ensure appropriate care in the shortest possible time, Bryant said.
The ED’s performance was also recognized last year when it was named a Best Overall Performer for Emergency Department flow by University HealthSystem Consortium (UHC) for the second time.
Thirty-one UHC hospitals participated in the benchmarking study. Wake Forest Baptist’s ED had the highest patient volume of the survey group with 89,743 annual patient visits. The overall average length of stay was 3.29 hours – the lowest of the group, which puts the ED in the lowest 25th percentile for Level 1 Trauma Centers. The ED’s composite score of 87.4 placed the department in the 87th percentile for all Press-Ganey hospitals, the 96th percentile for 50,000-plus visits and 97th for the UHC database.
“We work to move people through our Emergency Department as quickly as possible and we do it without compromising quality,” Bryant said. He is also quick to explain that each patient’s length of stay in the ED is determined by the severity of their situation related to the other cases being treated.
Bryant is proud of the numbers, considering the daily challenges faced, namely limited space. The ED logged 92,532 annual patient visits utilizing 52 treatment spaces. Of that number, 21.4 percent were admitted to the Medical Center for further care. Only 2.21 percent left the ED without being seen – one of the lowest scores of the survey group.
To further address the ED space issues, Bryant said, Wake Forest Baptist is planning a new $19 million pediatric ED that, when completed in 2011, will open up more space for the adult ED to move into, freeing up about 17 beds.