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Nyack Hospital
Nyack (N.Y.) Hospital was facing challenges typical of most emergency departments. The average ED length of stay was greater than 8 hours, walkouts exceeded 3% and patient satisfaction was at a challenging 17th percentile.
Once Emergency Medical Associates (EMA) partnered with Nyack Hospital, strong efforts were made to establish the ED as a highly efficient clinical operation. This included the provision of an experienced medical director, an ED operational support team to assist with strategy and implementation, an ED information system and analytics and dashboards.
Through the resources provided by EMA, Nyack Hospital was able to redesign its processes and introduce a 30 Minute Service Standard, where patients would be seen by a provider within 30 minutes of arrival to the emergency department.
The result was a reduction in walkouts to 0.5% (well below the national benchmark), nearly a 50% decrease in length of stay and a vaulting of patient satisfaction as high as the 99th percentile. Within the next 12 months, Nyack Hospital saw its volume increase by 17%, attaining dominant market share and favorable recognition as a quality provider of emergency care in the community.
Clara Maass Medical Center
The emergency department (ED) at Clara Maass Medical Center in Belleville, N.J., experienced steady volume growth over the past few years. With a 25% increase within the last 2 years, the challenge to manage the demand was very clear. Not only was there a need to expand capacity but also a need for changing operations to accommodate the growth without sacrificing quality and efficiency.
With EMA leading the effort, the medical center created a Rapid Decision Unit (RDU) adjacent to the ED. This was used for evaluation and treatment of patients who required further testing to determine if they required admission to the hospital. Operating the RDU allowed the ED to function more efficiently while simultaneously removing patients requiring further testing to a more comfortable and appropriate setting. In addition, quality of care was enhanced through better decision-making when admitting patients, and effectively reducing unnecessary admissions to the hospital.
Prior to the RDU, walkouts were nearly 6%, with a turnaround time of nearly 9 hours for admissions and almost 4.5 hours for discharged patients. One month after opening the RDU, the walkout rate was reduced by 50% as turnaround times began to decrease as well. In one year’s time, walkouts had been reduced to .8%, well below the national benchmark of 2%, while turnaround times for discharges and admissions decreased by 28% and 12%, respectively.
The ED is on track to see more than 70,000 patients annually with no signs of slowed volume growth. Thanks to the RDU initiative and Emergency Medical Assocaties' resources, those patients will receive expeditious care of the highest quality.
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