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Compirion Healthcare Cuts Emergency Department Throughput by 50% at the Medical Center of Central Georgia

MACON, Ga., May 26 /PRNewswire/ -- The Medical Center of Central Georgia has cut its wait times in half after an improvement project along the entire Emergency Service Line, including related inpatient departments, that began in June 2008. Medical Center leadership initiated the project after patient dissatisfaction with wait times in the Emergency Department became evident. To help create a strategy for reducing patient throughput, hospital leadership engaged Compirion Healthcare Solutions, a healthcare process improvement firm based in Elm Grove, Wisconsin.

Dr. DeLanor Doyle, an Emergency Department physician at the time of the improvement project, commented, "We were aware of the problem but not really the size of it, or that patients were waiting up to 15 hours to be seen. We also didn't know that hospitals of the same size had wait times as short as 2 hours."

Before the improvement over 14% of patients got frustrated and left without being seen (LWBS). The Emergency Department had to refuse emergency transfers most afternoons and evenings, that meant going on diversion about one third of the time. Inpatient beds were not available for those who needed admittance and patients with minor illnesses were waiting more than 6 hours to be treated before being released.

Barb Stickel, Senior Vice President and CNO added, "It was more like a holding center than an Emergency Department. We were not fully staffed and we were over capacity. We tried to fix things ourselves but the staff got discouraged. They wanted help."

Compirion Healthcare was selected upon a recommendation from another regional medical center located in nearby Columbus. Medical Center management liked that Compirion worked on site, hand-in-hand with hospital staff, rotating through all shifts, and that they guaranteed agreed goals would be met. Goals included: reduced length of stay from 16 hours to 8 for admitted patients and from 6.65 hours to 4.5 for discharged patients; increased patient volume from 132 to 150 per day; and elimination of diversion hours. Reducing the percentage of patients who left without treatment was also high on the list.

In June 2008, the Compirion team of three consultants arrived and began observing staff behavior and the day-to-day processes in the Emergency Department. After review, the Compirion team worked together with hospital personnel from management, Emergency and inpatient departments to set performance goals, identify pilot initiatives and to build Core Teams around these initiatives. Daily management, triage and bed control were identified early on as areas in need of improvement.

Compirion worked side-by-side with the core teams providing daily mentoring and coaching while allowing hospital personnel to do their own problem solving. The Compirion team supplied tools to aid in the collection and tracking of data. A constant process of piloting, implementing and evaluating became part of the daily regimen. Every Monday at 4:00pm the steering team met and reviewed the progress.

Doyle commented, "We realized we had to change our core processes. Triage became 'triage and treatment,' all in the front of the ED. We utilized unused areas as treatment areas. Patients can appreciate that we are trying to see them."

According to Lisa Bodell, Compirion Project Manager, "The front line management really took ownership. They retooled triage so that patients were being seen by a physician's assistant, nurse practitioner or a physician up front. This was the most significant step toward reducing door to admittance time. It also allowed non-critical patients to be treated, given a prescription and to leave quickly, effectively increasing billable patient volume and revenue."

Personnel were rescheduled around peak hours, which also alleviated wait times. A by-product of the rescheduling was an increase in labor productivity. The shorter length of stay had the effect of reducing the number of patients who left without being seen (LWBS) to 2.72% by the end of the project."

The chest pain center, which was originally on another floor, was moved into the Fast Track area closer to the emergency department so that chest pain specialists could assist in the Emergency Department in case of a crisis. This improved physician productivity and eliminated the need for hiring more physicians. From physicians to housekeeping, the entire staff began to take responsibility for patient comfort and care.

As a result of improved throughput, patient volume grew from 132 to 151 patients per day. To handle the increase in the Emergency Department, more inpatient beds needed to be available during peak hours. Hospital staff from the inpatient units pitched in to help the Emergency Department. They implemented several processes including a process they named Code Consensus. During a Code Consensus, a signal or code is delivered throughout the facility to expedite patient discharge, housekeeping and bed availability.

Stickel added, "The current code is the theme to the Lone Ranger. The first time we played it, we opened up 20 -25 beds in the first 2 hours."

Contrary to hospital expectations, the elapsed time for patient admission from the Emergency Department to inpatient units had dropped by 50%. The goal for ED outpatients from door to discharge had been set at 4.5 hours. In January, the hours had dropped from 6.65 to around 4 hours, well below the hospital's target. As wait times dropped, patient satisfaction scores climbed from the 9th percentile to above 90th percentile ranking.

According to Doyle, "Revenues went through the roof making Administration very happy! And, things continue to improve. We expect to finish $20 - $24 million more this year over last. I'd say we got our money's worth."

Stickel remarked, "This was one of the most positive processes I have participated in and I have worked with a lot of consulting firms. We have a big team working toward treating patients in a timely way. We can now handle 208 visits with few walkouts. "

Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion is a leader in healthcare consulting firms focusing on whole hospital process improvement. They work on site using a team approach and offer a money back guarantee that all goals are completed. Client hospitals show sustainable performance improvements in billable volume, patient satisfaction, core measures, length of stay, bed control, case management and staff retention. Their experience includes emergency room, surgical services, outpatient and inpatient nursing care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.

For more information on Compirion's sustainable healthcare solutions call 1-866-661-4677, or visit

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SOURCE Compirion Healthcare Solutions, LLC
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