Making Sure Patients Don’t Leave the ED Too Soon

Performance analytics can reduce the number of patients who leave without being seen and who leave against medical advice.

When patients leave an emergency department too soon, often due to extended wait times, they put both their health and the hospital’s reputation at risk. Long wait times may also present challenges in defending against malpractice lawsuits involving patients whose condition may have worsened because care was delayed.

What can be done to reduce the incidence of patients who leave without being seen and who leave against medical advice? Monitoring patients once they are admitted to the ED, providing updates on their plan of care, and reassessing their condition post-triage can help EDs reduce LWBS and leaving AMA.

Improving performance on these metrics can have a tremendous impact, including:

  • Eliminating errors
  • Preventing adverse outcomes
  • Increasing patient satisfaction
  • Improving reputation
  • Increasing revenue

Small Adjustments Can Make a Big Impact

Overall performance metrics — and LWBS in particular — are directly affected by several factors, including inefficient staff scheduling and low productivity of care teams. Meeting the needs of a high number of patients can overwhelm providers and compromise the quality of care. Optimizing physician scheduling by aligning physician productivity with patient arrivals can lead to substantial improvements in performance. Other factors that contribute to ED crowding and long wait times include lab work, delayed imaging services, and prolonged stays.

ED Performance and Patient Safety

When patients leave, not only are direct ED departmental revenues lost ($500 or more per LWBS), but hospital inpatient revenues are as well ($10,000 or more per LWBS) for any of those patients that might have been admitted.

Furthermore, the impact on patient safety and a hospital’s reputation can be equally significant.  Delayed access to care can be a trigger for malpractice litigation, just as prolonged wait times are tied to low patient satisfaction scores and negative online reviews. All this can damage an ED’s reputation and impact its bottom line. A health care organization may face additional liability if a patient’s condition worsens during his or her ED stay, or if the ED fails to reassess patients who have experienced excessive wait times, leading to premature discharge.

Purpose-Built Performance Analytics

It’s generally recognized that shortening patient journey times can help EDs reduce overall crowding and allow more patients to be seen without additional resources. Yet, it can be dangerous to focus on just one metric in isolation in an environment as dynamic as an ED.

Reducing LWBS and AMA requires tracking metrics that impact door-to-doctor time, patient flow, staffing, and resource utilization management. d2i’s Performance Analytics Application tracks the patient journey down to the lowest level of detail, capturing time increments and activity for each patient touch point, service, and movement. We help ED stakeholders track arrivals by hour of day, day of week, and acuity to provide insight into how best to optimize provider scheduling.

Explore the power of purpose-built analytics by scheduling a 30-minute demo with one of our domain experts, or learn more about how our specialty-specific tools enable performance improvement conversations within your organization.