The High Performance ED

Optimizing Capacity and Throughput to Meet Ever-Growing Demand

21 best practices to alleviate ED capacity crunch and optimize operations.

Executive Summary

Confronting the ED crisis

Emergency departments across the country are in a state of crisis. Between 1997 and 2005, over 200 EDs shut their doors—primarily the result of hospital closures and mergers. At the same time, demand for emergency services has soared, fueled in large part by the loosening of managed care’s grip on ED use, a rise in the uninsured population, and constricting primary and psychiatric care access. With these trends, the majority of hospitals are struggling to keep up, with many (if not the vast majority) either at or over capacity.

Addressing capacity constraints

Addressing ED efficiency begins with determining if resources are being deployed as efficiently as possible. We examine ideas for promoting principled and appropriate ED utilization while also focusing on reforming core ED processes, such as refining the initial steps of the patient visit before the physician assessment.

Promoting bed availability

While reforming these processes is key to optimizing throughput, it is often only half of the equation; improvements will often be limited if inpatient bed availability isn’t also addressed. As such, we outline approaches to ensure bed availability for ED patient admissions, which includes a focus on alleviating the burden of caring for inpatients which are boarded within the ED.

Leveraging data and technology

Finally, we tackle the important issue of utilizing data and technology to optimize ED efficiency, with a special focus on patient tracking systems, optimal staffing structure and communication, and performance monitoring through best-in-class dashboard and ED business intelligence tools.

Creating a culture of accountability

While the best practices outlined in this publication are all important with regard to optimizing capacity and throughput, progress will be limited without a parallel commitment to creating a culture of accountability. Access the full study to learn how to hardwire long-terms gains in ED efficiency through the education and buy-in of the entire hospital team.

The current struggle to meet the ever-growing demand for emergency services is exacting a significant toll on many organizations. Substantial waiting room queues and extensive lengths of stay compromise quality of care by preventing timely provision of clinical care for even the most acute patients. This publication will help hospitals optimize throughput and capacity of the hospital-based ED through focus on these key areas:

  • Addressing capacity constraints
  • Reforming core ED processes
  • Promoting bed availability
  • Hardwiring long-term gains

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