Emergency Department

The Problem

Patients at a 234 bed Children’s Hospital serving a large metropolitan area were experiencing long delays when being admitted for treatment from the emergency department. In addition to the discomfort such delays were causing patients and their families, they were also resulting in diversions, increased operating costs and reduced throughput capability for the healthcare facility.

The Approach

A comprehensive process improvement analysis of the Emergency Department Admissions and Discharge process was performed by Empirical Solutions Corporation which included the following phases of analysis:

• Stakeholder interviews.
• Current process mapping.
• Detailed process analysis including data logging and variability analysis.
• Value stream process mapping of the improved process.
• Quantification of the impact of proposed modifications on system performance measures (flow times, delay times and overall length of stay).
• Recommended interventions to achieve the proposed process.

Significant Results

Within six months of implementation of the study recommendations, the following quantifiable performance improvements were obtained:

• Emergency department admission flow times decreased by 22%.
• Emergency department discharge flow times decreased by 14%.
• There was a 21% reduction in the number of steps involved in the future state admissions process value stream map and an associated reduction in the number of interdepartmental communications required.
• There was a reduction in the variability associated with the bed assignment process which resulted in a 6% decrease in mean bed assignment process flow time.
• There was a reduction in the variability associated with the MD discharge order process time which resulted in an 11% decrease in the mean discharge order to disposition process flow time.