*‡; Fran Bartholomeaux, RN, MS‡; John Guisto, MD*‡; Elizabeth Lindberg, MD*‡; Becky Hull, RN, MS‡; Alicia Eyherabide, RN, MS‡; Sally Lanyon, RN‡; Elizabeth A. Criss, RN, MEd*; Terence D. Valenzuela, MD, MPH*‡; Carol Conroy, PhD*">
Rapid process redesign in a university-based emergency department: Decreasing waiting time intervals and improving patient satisfaction☆
Received 8 November 1999; received in revised form 3 November 2000, 24 May 2001 and 10 September 2001; accepted 11 October 2001.
Refers to article:
Analysis of pediatric hospitalizations after emergency department release as a quality improvement tool
Andrew D. DePiero, Daniel W. Ochsenschlager, James M. Chamberlain
Annals of Emergency Medicine
February 2002 (Vol. 39, Issue 2, Pages 159-163) Abstract |
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Full-Text PDF (65 KB)
Abstract
Academic emergency departments are traditionally associated with inefficiency and long waits. The academic medical model presents unique barriers to system changes. Several non–university-based EDs have undertaken process redesign, with significant decreases in patient waiting time intervals. This is the presentation of a rapid process redesign in a university-based ED to reduce waiting time intervals. We present the application of a process-improvement team approach to evaluate and redesign patient flow. As a result of this effort, the median waiting room time interval (triage to patient room) decreased from 31 minutes in January 1998 to 4 minutes in July 1998. ED throughput times also decreased, from 4 hours, 21 minutes in January 1998 to 2 hours, 55 minutes in July 1998. Urgent care waiting room time intervals decreased from 52 minutes to 7 minutes and throughput times from 2 hours, 9 minutes to 1 hour, 10 minutes. Patient satisfaction evaluations by an independent institute demonstrated dramatic improvement and establishment of a new benchmark for academic EDs. Process redesign is possible in a busy, complex, tertiary-care ED, with decreases in waiting time intervals and improvement in patient satisfaction. Major sustained support from top-level hospital administrators and physician leadership are fundamental prerequisites. With these in place, a process improvement team approach for evaluating and redesigning the patient care system can be successful. [Spaite DW, Bartholomeaux F, Guisto J, Lindberg E, Hull B, Eyherabide A, Lanyon S, Criss EA, Valenzuela TD, Conroy C. Rapid process redesign in a university-based emergency department: decreasing waiting time intervals and improving patient satisfaction. Ann Emerg Med. February 2002;39:168-177.]
From the Arizona Emergency Medicine Research Center, the Department of Emergency Medicine, College of Medicine, University of Arizona,* and the University Medical Center,‡ Tucson, AZ
☆ Address for reprints: Daniel W. Spaite, MD, Arizona Emergency Medicine Research Center, Arizona Health Sciences Center, Box 245057, Tucson, AZ 85724-5057;,520-626-7957, fax 520-626-2480;,E-mail dan@aemrc.arizona.edu .