No less than ten years ago, there was a little secret about how to secure first class status on airlines. If you simply approached the gate attendant about an hour before the flight left, looked kind, and asked quietly if there were any first class upgrades available, 8 out of 10 times you would get upgraded. This was true no matter what your status was. Airlines got wise to this, and changed the policy to a “status” structure.
I read this article from CNN about hospital ED throughput, and thought of my earlier airline experience.
What if everyone who presents in the Emergency Department casually drops the name of their dear friend, the CEO, or their Uncle who is the Chair of the Board, or their Grandmother a major donor? Imagine the stress on your staff!!!
Long waits in the ED have quality of care ramifications. In April 2008, the Government Accountability Office, using 2006 data, found that the average waiting time nationally was twice that recommended for the most urgent cases. People who should have been treated in 1 to 14 minutes were being seen, on average, in 37 minutes.
Press Ganey found that the average ER waiting time last year was 4 hours, 2 minutes! Yes, Press Ganey did report a slight improvement from the prior time period (2 minutes). However, throughput was seen as an area which could significantly impact satisfaction. The report stated: “Improving the actual flow of patients through the hospital impacts the entire organization down to time spent in the emergency department. Most emergency department physicians and staff know that the emergency department is at the mercy of the inpatient capacity and census.”
The answer, like the airlines, is to develop a system for ensuring that patient throughput improves. The answer is not as simple as saying to the staff “See patients quicker.” It involves making sure that equipment is available when you need it, clean beds are available for transfer of ED patients, and even that patients might know that their EDs have capacity.
If you want to see an example of a hospital that alerts its community to approximate wait time in the Emergency Department, check out Mountain States Health Alliance, www.msha.com, which posts their wait times directly on the ED…and allows patients to see which of their hospitals EDs wait times are short. The wait times are updated continuously.
By improving patient throughput, and allowing patients to know up front their waits, ED staff may be less likely targeted for name dropping…and allowed to spend more time taking care of patients.
