Thanks to revamping the way it handles emergency care, Parkland Memorial Hospital in Texas expects to boost its ED visits by one-third in the coming year, reports the Dallas Morning News. Most of the 200,000 treated will not so much represent new patients, but a declining percentage of people who tire of waiting and leave the hospital before being seen, said Dr. Brent Treichler, who as the hospital's chief of emergency medicine oversaw the initiative.
Before making changes such as handling less serious cases in an urgent-care clinic on another floor, adding clinicians and dividing them into five teams that could more quickly assess a patient's condition and provide treatment, patients waited an average of four hours to be seen by a doctor, and spent a total of eight to 13 hours from arrival to discharge or admittance. It now takes an average of 54 minutes to see a doctor and five hours and 26 minutes for the entire ED encounter, officials report.
But with the surge in ED volume, securing one of the hospital's 685 beds for those who must be admitted remains a challenge. The average total wait or "dwell time" for these patients, among the sickest seen in the ED, is eight hours and 49 minutes. Although the hospital has recently managed to cut that time by about 90 minutes, Dr. Ron Anderson, Parkland's president and CEO, said the increased patient load makes the case for adding about 30 percent capacity in the new Parkland hospital scheduled for completion in 2014.
Meanwhile, St. Mary's Hospital in Kitchener, Canada, is celebrating cutting its arrival-to-admission time from 42 hours in 2008 down to less than 24 today. The results were so dramatic, in fact, that St. Mary's General Hospital received a one-time performance bonus of $530,000, earmarked to continue lowering wait times at the hospital and share lessons learned with other hospitals, reports TheRecord.com.
As with Parkland, St. Mary's cut its wait time by changing the layout to move non-urgent treatment to another area, and by expanding the role of nurses to provide minor treatment and speed triage.