IRVING, TX -- 11/02/09 --
Rapid treatment in the emergency department is
key for serious medical issues, and it's an overall driver for patient
satisfaction, which is a new measuring stick for Medicare reimbursement.
However, it's becoming more difficult to accomplish this goal due to rising
ED volumes, driven by the poor economy and the influx of patients due to
the flu season.
Since 2005, 28 hospitals in Oklahoma and Arkansas have worked together,
through VHA Inc., the national health care network, to identify ways to
improve ED throughput. Building an efficient ED system takes intense
coordination across a hospital, meaning patient assessments must be
correct, lab tests must be performed in an accurate and timely manner, and
imaging and surgical resources must not be bottlenecked.
National ED wait times hover around 156 minutes, but some hospitals in
Oklahoma and Arkansas have managed to treat patients in as little as 97
minutes. This means they can see more patients during a given 24-hour
period, which is crucial to hospital finances since the ED is a dominant
source of hospital admissions, and it drives revenue through the use of
lab, surgical, imaging and ancillary services.
Another measure of ED efficiency is the percentage of patients who "leave
without being seen," commonly referred to in the industry as the LWBS rate.
This measure reflects the number of patients who get tired of waiting to be
seen, and leave before being treated. Each patient who leaves represents a
loss of potential income for the organization, as much as $300 per patient.
Using that metric, seeing an additional 5,000 patients annually in the ED
would generate an additional $1.5 million in net revenue.
The national LWBS average is around 2% to 3%. Eleven of the 28
participating hospitals have rates below the national average, and some
Oklahoma and Arkansas hospitals have reached near zero for LWBS. All of
this has occurred despite emergency room volumes that are on average 13%
higher than 2005 levels at the participating hospitals.
"We have tracked steady improvement across many ED measures for the
participating hospitals, compared to national standards," said Bruce
Naylor, M.D., vice president of clinical improvement for VHA's regional
office in Oklahoma City, "but the real driver for improvement for these
hospitals is not comparing themselves to national standards, but with each
other. Once a hospital administrator sees that another hospital has
achieved success, he or she picks up the phone and asks how. That's the
power of VHA; it's hardwired into our members to connect with one another.
We open doors for the sharing of best practices and tools that support
improvement. That's going to be the key to improving health care across
the nation."
One of the participating hospitals, Comanche County Memorial Hospital in
Lawton, Okla., has experienced a 33% increase in ER volume since 2005. In
the face of this marked increase in volume, the ED has decreased length of
stay by almost an hour and dropped its LWBS rate by 6%, according to Randy
Segler, chief executive officer of Comanche County. "That 6% decrease in
LWBS rate means that our ED is now seeing about 3,000 more patients per
year, patients who previously left before care could be provided. Now they
are being seen in a timely manner and given the care they need. Our team
is very proud of that improvement," said Segler.
Keys to Improving Services:
-- Utilize a visible, involved, experienced triage nurse
-- Train staff to use established triage protocols
-- Perform patient assessments separate from triage
-- Ensure that triage results drive bed or room placement for patients
-- Perform registration at the patient bedside
-- Ensure that physicians and nurses perform as teams
-- Implement patient tracking systems
-- Employ throughput-focused physicians in the ED
About VHA
VHA Inc., based in Irving, Texas, is a national network of not-for-profit
health care organizations that work together to drive maximum savings in
the supply chain arena, set new levels of clinical performance, and
identify and implement best practices to improve operational efficiency and
clinical outcomes. Formed in 1977, through its 17 regional offices, VHA
serves more than 1,400 hospitals and more than 24,000 non-acute care
providers nationwide.
BACKGROUND
Twenty-eight hospitals participate in the VHA Oklahoma/Arkansas Emergency
Department Collaborative:
CITY STATE
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Arkansas Methodist Medical Center Paragould Ark.
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Baptist Health Medical Center North Little Rock Ark.
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Baptist Health Medical Center Arkadelphia Ark.
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Baptist Health Medical Center Little Rock Ark.
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Comanche County Memorial Hospital Lawton Okla.
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Conway Regional Medical Center Conway Ark.
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Duncan Regional Hospital Inc. Duncan Okla.
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Grady Memorial Hospital Chickasha Okla.
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Great Plains Regional Medical Center Elk City Okla.
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INTEGRIS Baptist Medical Center Oklahoma City Okla.
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INTEGRIS Baptist Regional Health Center Oklahoma City Okla.
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INTEGRIS Bass Baptist Health Center Enid Okla.
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INTEGRIS Grove General Hospital Grove Okla.
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INTEGRIS Southwest Medical Center Oklahoma City Okla.
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Jackson County Memorial Hospital Altus Okla.
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McAlester Regional Health Center McAlester Okla.
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Memorial Hospital of Texas County Guymon Okla.
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Moore Medical Center Moore Okla.
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Norman Regional Health System Norman Okla.
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Parkview Hospital El Reno Okla.
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Piggott Community Hospital Piggott Ark.
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St. Bernard’s Medical Center Jonesboro Ark.
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Stillwater Medical Center Stillwater Okla.
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Tahlequah City Hospital Tahlequah Okla.
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Unity Health Center Shawnee Okla.
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Valley View Regional Hospital Ada Okla.
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Washington Regional Medical Center Fayetteville Ark.
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White County Medical Center Searcy Ark.
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Media Contact:
Lynn Gentry
972/830-0798
Email Contact
