When you can’t increase your staffing or control the number of patients coming through your doors, d2i can help you allocate existing resources to better handle your patient flow.

d2i’s performance analytics solutions drill deeper into data to identify specific opportunities to help you improve processes.

As Emergency Medicine faces changes in the future of health care and evolving government regulations, Emergency Departments (EDs) are pressured to pursue excellence through performance and process improvement across a broad spectrum of areas, including quality of patient care, service delivery, risk mitigation, and profitability.

Common issues like overcrowding or staffing can have a direct impact on operational efficiency, the cost per intervention, clinical workflow, and ultimately, patient satisfaction. EDs need timely access to actionable information to inform decision-making and enable the organizational discussions and collaboration that are necessary to fix problems. Let’s take a quick look at four common ED issues and how effective analytics tools can improve performance.

1. Overcrowding

More than 90% of EDs in the United States report crowded conditions on a routine basis. Aside from being associated with increased mortality rates, ED crowding can affect your facility in several significant ways, including:

  • Excessive wait times
  • Patients leaving before being seen (LWBS)
  • Poor patient satisfaction scores
  • Increased adverse events
  • Poor ED staff satisfaction

How analytics can help: Accurately assessing ED crowding and its causes can help identify bottlenecks and address contributing issues. But this type of analysis requires a deeper look into the data than can be offered by an EHR system or many of the enterprise-wide data analytics tools out there. To get a handle on hard-to-predict patient flow, look for a robust analytics platform that can help you identify and measure the severity of ED crowding while monitoring the effectiveness of efforts to eliminate it.

For example, d2i’s Census and Arrivals analytics are built to help identify the timing and frequency of peak ED crowding during periods of full staffing. The Census and Arrivals report provides an hourly average census grouped by acuity level, area of the ED, and status of service. Comparing this to the number of available treatment spaces allows you to assess total hours over capacity, the percent of hours above capacity, and more.

2. Patients Leaving the ED (LWBS and AMA)

There are many reasons that contribute to patients deciding to leave the ED, either against medical advice (AMA) or without being seen. This can put both their health and the hospital’s reputation at risk. Their condition may also worsen due to the delay in care, potentially presenting challenges in defending against malpractice lawsuits. Also, when patients leave, not only are direct ED departmental revenues lost, but hospital inpatient revenues may be, too.

How analytics can help: Reducing LWBS and AMA requires tracking metrics that impact door-to-doctor time, patient flow, staffing, and resource utilization management. Provider scheduling can be optimized by tracking arrivals by hour of day, day of week, and acuity, and by capturing time increments and activity for each patient service or movement.

3. Impact of Staffing

Recent research shows that lower nurse staffing levels can negatively affect performance metrics, showing a correlation between adequate nurse staffing and patients’ length of stay (LOS) and with the number of patients LWBS. There’s also evidence that improving physician productivity can reduce unmet patient demand (the number of patient arrivals above average physician productivity). Interestingly, other research shows that fewer nurses could actually be optimal, which could save on ED staffing costs.

How analytics can help: Looking at just one correlation can be misleading due to the dynamic nature of the ED environment. Using advanced, purpose-built analytics for the ED can provide insight into how to dynamically allocate nursing and physician hours.

4. Overuse of Tests, Treatments, and Procedures

Consumerism and price transparency have forced the overuse of some tests and procedures into the forefront as legitimate issues to be addressed. Lean management of an ED necessitates the most efficient operations, including curbing expensive, unnecessary testing. One recent study concluded that pediatric EDs in the United States are using certain low-value imaging up to 10 times more often than those in Canada, adding to costs and lowering the quality of care. It’s important to establish treatment protocols because some insurers have been denying claims for ED visits they deem inappropriate.

How analytics can help: An effective performance analytics solution can help you sort through data to determine whether some physicians are ordering tests or procedures at a much higher rate than others, or to look for conditions where the tests and procedures aren’t indicated. Finding a solution that supports your quality improvement initiatives can lead to better outcomes, including reduction of overuse.

Improving performance is only possible when decision-makers have access to a comprehensive toolset, one that presents a 360-degree view of performance, provides root-cause analysis, and monitors the impact of operational changes. Explore how d2i can help your ED prove its value and improve performance by scheduling a 30-minute demo with one of our domain experts.

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