Know the score; track data to fi nd areas of improvement Tracking a few key metrics helps clinicians and hospital leaders monitor results and more easily identify areas for im- provement. Wellsoft EDIS automatically captures, time-stamps and tracks patient wait and activity times at each step of the emer- gency department visit. Patients are tracked from pre-admission through fi nal disposition and time-stamps correlate to each patient’s overall length of stay (LOS) in the ED. Bottlenecks are easily identifi ed. With data collected on patient fl ow, action
ED SCORE CARD EXAMPLE
Last 3 months
Budgeted patient visits
Actual patient visits
Actual patient visits (last year)
Left without treatment
# of ED discharges
Average length of stay
# of ED
LAB (order to completion)
Radiology (order to completion)
X minutes X minutes
Process times Arrival - Triage X minutes X minutes
Triage - Placed on bed
Seen by M.D. Disposition Left ED
X minutes X minutes X minutes
Patient satisfacton % Use a scorecard to monitor, manage and prioritize. www.healthmgttech.com X minutes X minutes
plans are being developed to improve throughput time, which, in turn, will increase patient satisfaction.
The team at Huntsville Hospital has created a monthly dash- board that includes key data generated during and after each ED patient visit. This dashboard is shared with senior leader- ship to track the impact of process changes and improvements throughout the hospital.
Drilling down on any monthly metric variance to understand what was occurring on a specifi c day of the week, at a specifi c time, helps to identify potential process improvements. If the door-to-triage times are within range, except between noon and 3 p.m. each afternoon, this might prompt the need for a greeter. This process change could be easily implemented and then observed to determine if the change works. For Huntsville Hospital, having an EDIS that essentially writes its monthly ED scorecard reports automatically is invalu- able. Without an EDIS, there is no easy way to collect data and measure patient throughput. To provide metrics on a monthly basis would require manually reviewing hundreds of paper charts. The data would be subjective, and you would hope you have the right information and are reaching the right conclusions. It would be like driving a bus blindfolded. You might someday reach your destination, but getting there would be diffi cult.
Change is good
The team at Huntsville Hospital welcomes and embraces change, which helps them realize their objective of improving effi ciency. Refl ecting staff members’ input helps optimize workfl ow.
For example, when ED physicians suggested a new way to help improve patient communication, the idea was quickly made a reality. The appeal was for a way to document and track patient requests, such as “patient is hungry,” “patient wants to see doctor” and “patient’s family has questions” right on the ED patient track. With a few simple changes, a new tracking column was added to the patient track. As requests are made, they are entered into a “patient request” column and color coded to identify what is requested, who should handle the request (doctor, nurse) and if the request has been fulfi lled.
This simple change means ED staff no longer has to write down patient requests and hope they remember to take care of them. Doctors and nurses are more organized, and patients are happier.
Sometimes change is unexpected Even an ED has to be prepared for an emergency. During the H1N1 pandemic outbreak in 2009, the Alabama Department of Health required daily electronic reports with information on the number of patients presenting with fl u symptoms, the number of patients tested and the number of patients confi rmed with the virus. Without an EDIS, Huntsville Hospital would have had to manually review more than 400 patient charts to tally the infor- mation. With Wellsoft EDIS, a sort fi lter was created and reports
HEALTH MANAGEMENT TECHNOLOGY December 2011 17