Fixing ED Throughput: Studies Show Associated Reductions in ED LOS & LWBS Rates

emergency dept signED throughput is a chronic source of delays and headaches for many hospitals.

Over more than 25 years spent as the medical director of a community Emergency Department (ED), Richard Bukata MD, says, “it became very clear how to make a great ED: have a CEO who wants to have a great ED.”

In an article originally published on Emergency Physicians Monthly and reprinted on MedPage Today titled ED Throughput: A Fixable Problem, Dr. Bukata delves into two examples of recent studies that showed improvements in ED Length of Stay (LOS) and Left Without Being Seen (LWBS) rates as a result of top-down ED throughput improvement initiatives.

“A consistently crowded ED is an engraved invitation for the local entrepreneurial physicians in the community to start an urgent care center that will skim off all of your ED’s insured easy patients, leaving the ED with the rest,” Dr. Bukata explains, urging hospital leaders to seriously address ED throughput in order attract (and retain) more patients over the long term.

One of the studies cited in the piece, from the Journal of Emergency Medicine, found that one of the five Scripps hospitals in San Diego redesigned the facility to streamline throughput, and found what Dr. Bukata calls, “some absolutely remarkable results”

Despite the fact that admission rates remained consistent, average door-to-provider times dropped by almost 80%, from 127 minutes to just 26 minutes. Average ED length of stay was also reduced dramatically, from 5.5 hours to 3.6 hours, and LWBS rates dropped from a staggering 8.7% to just 0.2%.

The second study,from Kaiser Permanente, found similar correlated improvements to ED LOS and LWBS rates after establishing two ED throughput goals: a 30-minute goal for bed assignment and a 30-minute for patient placement once a bed is assigned.

While the hospital staff was only able to meet these goals 58% of the time, they achieved some significant residual improvements as a result, including reducing discharged patient LOS and admitted patient LOS by almost an hour and just under two hours, respectively. LWBS rates dropped from 1.2% to just 0.6%.

Dr. Bukata praises the two hospitals for sharing their less-than-stellar “before” performance data, and asserts that, “Thankfully, you can actually change the trajectory of your ED.”

“These changes occurred because the hospital administration (along with the ED staff) wanted them to occur.”

Throughput technology tools like BedWatch provide the real-time visibility and communication tools necessary to break down silos and drive lasting improvement across patient throughput processes. Our comprehensive reporting tools and dynamic, real-time dashboards ensure that hospital leaders and front-line staff alike are able to make informed decisions at the point of care.

For more information about how the BedWatch suite of technology tools can streamline patient throughput from the ED through the entire length of stay, please contact us.

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