Rapid process redesign in a university-based emergency department: Decreasing waiting time intervals and improving patient satisfaction

Daniel W. Spaite, Fran Bartholomeaux, John Guisto, Elizabeth Lindberg, Becky Hull, Alicia Eyherabide, Sally Lanyon, Elizabeth A. Criss, Terence D. Valenzuela, Carol Conroy

Research output: Contribution to journalArticlepeer-review

137 Scopus citations

Abstract

Academic emergency departments are traditionally associated with inefficiency and long waits. The academic medical model presents unique barriers to system changes. Several non-university-based EDs have undertaken process redesign, with significant decreases in patient waiting time intervals. This is the presentation of a rapid process redesign in a university-based ED to reduce waiting time intervals. We present the application of a process-improvement team approach to evaluate and redesign patient flow. As a result of this effort, the median waiting room time interval (triage to patient room) decreased from 31 minutes in January 1998 to 4 minutes in July 1998. ED throughput times also decreased, from 4 hours, 21 minutes in January 1998 to 2 hours, 55 minutes in July 1998. Urgent care waiting room time intervals decreased from 52 minutes to 7 minutes and throughput times from 2 hours, 9 minutes to 1 hour, 10 minutes. Patient satisfaction evaluations by an independent institute demonstrated dramatic improvement and establishment of a new benchmark for academic EDs. Process redesign is possible in a busy, complex, tertiary-care ED, with decreases in waiting time intervals and improvement in patient satisfaction. Major sustained support from top-level hospital administrators and physician leadership are fundamental prerequisites. With these in place, a process improvement team approach for evaluating and redesigning the patient care system can be successful.

Original languageEnglish (US)
Pages (from-to)168-177
Number of pages10
JournalAnnals of emergency medicine
Volume39
Issue number2
DOIs
StatePublished - 2002

ASJC Scopus subject areas

  • Emergency Medicine

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