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This is always a political question that cannot be fixed by the ED leadership alone. And there are lots of ways to improve this number, from streamlining the nurse reporting system to boarding patients in the hallways of the floors to which they are going instead of the ED.
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This is a question of hospital culture and must be handled with the full cooperation of administration and nursing.
The question is whether your floors are pulling the patients up or is the ED having to push the patients.
In most EDs, in fact, more time is spent on this end of the equation than all of the “value added” time being seen and evaluated by the staff. The average of all EDs is a little over 2 hours, but the average ED with a census of over 70 thousand patients is over four hours. Once the decision is made to admit, how long does it take to actually leave the ED? Given the state of EDs around the country, the current “excellent threshold” is 100 minutes. This is a valuable tool in speaking to administrations about changing staffing, facilities, and other bottlenecks that are out of the control of the doctors. The fact that he waited an hour in the waiting room and only 5 minutes in the room doesn’t change his impression of the wait. Remember that the patient only remembers how long it took to see the doctor. You must move away from the traditional front-end processing that most EDs are still using. This allows administration to follow the patient instead of holding up the patient. You can use virtual beds where patients get a brief exam where orders are written and then patients return to a holding area.
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But you can still make it work if you find ways to move the physicians as far forward as possible, using parallel processes instead of serial processing. If you have a lot of patients competing for a few beds, low doctor-to-room times will be hard to achieve. This parameter is largely influenced by the ratio of patients to beds. An average performing ED will be about 25 minutes with the best EDs clocking in under 5 minutes. The number of minutes that have passed between the patient’s arrival and being placed in a patient care area is the best indicator of your ED’s front end processes. That said, the average ED has a hard time getting this number under an hour.
The “excellent” threshold is less than 30 minutes with the best EDs at about 10 minutes. Meet this expectation and you will satisfy most patients, the administration, and provide high quality care. We need to find out who is sick in the least amount of time.
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The number of minutes from patient arrival to seeing a doctor or a mid level provider is the number one concern for patients and may be the best driver for excellent patient care. Here are some of the top benchmarks that should matter to emergency physicians. They can help you move beyond reactive evaluation related to a complaint, a poor patient satisfaction score or a suit, when you might not focus on the best things for improvement. Why should we care about benchmarks? They are a way to be proactive in evaluating and improving your practice before you get criticized, fired, or have your compensation reduced. Become a student of your ED’s stats and move from being a reactive to a proactive problem solver