A year ago, Martin Memorial Medical Center was searching for ways to improve the structure and flow of its emergency department.
Like a lot of hospitals in Florida, the emergency departments at Martin Memorials two hospitals were barraged during the winter months, when seasonal residents swell the population. In the 2006-07 season, patients were waiting between five or six hours to see a physician at the Medical Center the larger of the two hospitals with the emergency department lobby and hallways stuffed with patients. Worse yet, many were leaving without being seen.
“The place was absolutely packed last year,” said Dianne Harmon, director of the Medical Center emergency department.
To remedy the situation, Martin Memorial has made significant changes to the emergency department flow, allowing patients to see doctors faster with a more efficient system. The new processes began Feb. 20, 2008 and signs of improvement have already begun to surface.
In March, traditionally the busiest month of the year, the emergency department saw more than 3,200 patients but patients were still placed in a room within 45 minutes and seen by a practitioner in 60 to 90 minutes. In a snapshot of how the process has improved since then, all 92 patients that visited the Medical Center emergency department on April 20 were taken to a room within eight minutes, with the average time to see a practitioner at 25 minutes.
“Its a cultural change,” Harmon said of the new process. “But our patients are happier and our flow is better.”
Immediately after the season ended in 2007, Martin Memorial officials began to look at ways to improve the system.
In October 2007, a multidisciplinary team with representatives from around the hospital was brought together to break down the emergency department process. Team members went through the same steps a patient would in order to understand where there were opportunities for improvement, examining everything from hospital signage to the ambiance of the lobby.
As a result, the number of steps it took to see a practitioner from the time a patient walks into the door went from 14 to three. The lobby area was renovated so that patients are greeted by one person, a patient care technician, who is able to quickly begin the process.
The PCT takes vital signs and puts a band on the patients, then brings them to the back. Bedside registration, nursing assessment and workups are done in the patient care area, rather than being started in the lobby.
Plus, a sub-waiting room was created as an offshoot of the emergency department. There, patients with less acute injuries or ailments can be evaluated and treated without taking up valuable bed space. It also allows them to be treated and released more quickly.
The results have been rewarding. In February and March 2007 there were 5,682 ED visits, including 243 patients who left without being seen. During that two-month time period in 2008 there were more ED visits (5,998) but fewer patients left without being seen (117).
“Its made an unbelievable difference,” Harmon said of the new system. “Our lobby seems like its always empty. And most importantly, the patients are happier.”
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