Emergency Department Process Redesign at Northern Westchester Achieves 99% Patient Satisfaction
(10/6/2008)

When you walk into Northern Westchester Hospital's Emergency Department, you will notice something different—the waiting room is empty. And why is that? Because the Mt. Kisco, NY-based care facility has a new process, which requires that a patient be assessed by a triage nurse within moments of arrival and seen by a physician within 30 minutes. The MEDITECH Emergency Department Management (EDM) application supports the collection of important reporting elements and provides the functionality to triage, track and record treatment of the patient during the ED visit.

"More than 50% of our inpatients arrive through the Emergency Department and the community has high expectations regarding the level of care they will receive once they get here," said Peggy Piering, RN, MS, director of emergency services and critical care at Northern Westchester. "Our redesign process goals were to make the Emergency Department visit more efficient and faster, and to improve patient and staff satisfaction by utilizing the EDM software."

Under the guidance of Susan Etkin, senior vice president of Harris McCully Associates, Inc., over 50 staff members, representing all areas of the hospital, participated on the redesign team. Every detail of the Emergency Department experience was analyzed, from triage to inpatient admission (or discharge). The new process includes a brand new infrastructure, which uses EDM as its foundation. The redesign also resulted in the following new elements to their care process:

• Clinical Teams—a doctor, nurse, technical associate, and business associate comprise one team, and their patients are color coded on the ED tracker for easy identification and accountability.

• Flow Coordinator—a nurse who manages patient flow utilizing the ED Tracker continuously.

• Business Associate—dedicated clerical support enables the clinical team to focus on patient care. MEDITECH bedside registration is performed by these dedicated resources.

• Additional Results Indicators—Established 16 vital tests that are on the Tracker to support clinical decisions regarding treatment and discharge/admit process.

• Established Turnaround Times—Acceptable turnaround times were set up within MEDITECH for Laboratory and imaging results, as well as procedures that are monitored via the Tracker.

• Established Times for Door to Doctor, Doctor to Decision, and Decision to Floor/Discharge—MEDITECH reports help to monitor and improve processes continually to meet the expected time parameters.

• CPOE—99% of all ED orders are entered into MEDITECH via CPOE; Northern Westchester is planning to implement the eMAR and Bedside Verification software before the end of 2008.

"Virtually everyone at Northern Westchester is touched by these changes," remarked Steve Grayson, MD, associate medical director in the Emergency Department. "We created and implemented a variety of modifications that improve the flow of patient care both in the Emergency Department and throughout the hospital.

"During March, April, and May, we showed a rise in patient satisfaction scores from 78% to 88%," continued Grayson. "And now, today, our scores are at a 99% patient satisfaction rating. You can't get much higher than that."

 

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