CASE STUDY

Seaside Emergency Associates

Employing Drill-Down Data to Reduce Door-to-Provider Time and Walkouts in Two California Emergency Departments

For Ventura County Medical Center and Santa Paula Hospital in Ventura County, California, the quest for improving quality and operations was the driving force behind implementing d2i. At 107 and 44 visits per day respectively in their Emergency Departments, VCMC and SPH were using reports from their Cerner EHR, along with manual spreadsheets, to compile and analyze data. This required a large number of staff hours and, while there was some benefit, the effort provided little actionable data to support their quality improvement initiatives.

Seaside Emergency Associates (SEA), a 25-provider group with 8 APPs, came to the conclusion that they wanted an application to be the catalyst for improving their quality measures and operational performance. SEA leadership lobbied for a year to get d2i’s Performance Dashboard into their emergency departments. Once d2i staff demonstrated the value and power of their analytics, approval was easy. It took 3 months from contract signing to SEA’s dashboards being live. The group was motivated more from an operational standpoint than a financial one, their primary goal being to identify performance issues, make operational changes, and then measure impact.

VCMC and SPH were able to improve Door-to-Provider time and reduce walkouts by empowering staff to leverage the information provided by d2i’s solution. The ability to drill down on the data uncovered bottlenecks on Mondays and showed that staffing was inadequate in the earlier hours of the day. By looking at hourly arrivals, the Medical Director was able to make decisions about how staffing could be optimized to address the gaps. Three months after implementing the changes, the group saw significant improvements.

At VCMC, Door-to-Provider time was 10 minutes longer on Monday than all other days combined, and walkouts were nearly double the other days of the week. Using d2i, SEA was able to analyze their hourly arrivals and implement a new mid-level shift from 8a-1p. The result: LWBS was reduced by 40 percent. The group also initiated a “pull-to-full” approach, which shaved 11 minutes off Door-to-Provider time. At SPH, SEA used data from d2i to determine that they needed rapid triage, mid-shift coverage, and a meet-and-greet program. Over the next 5 months, LWBS dropped from 3.5% to 1.3%.

Working with d2i staff, SEA created a report that allowed them to track compliance with clinical practice guidelines. They can now chart review fallouts and consider that data when making decisions on peer review and provider feedback. Using a variety of operational, quality, and satisfaction data from d2i’s solution, the group also provides quarterly reports to physicians on their performance and compliance.

“d2i has been instrumental in equipping us with the proof to show providers and administration that these initiatives are working,” says Rutherford. “It is this data that has enabled us to solidify the movement toward what has become an immensely positive change for both facilities.”

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Client

SEA, Ventura County, California

Annual ED Visits

39,000 at Ventura County Medical Center; 16,000 at Santa Paula Hospital

EHR System

Cerner

Solutions

d2i’s ED Performance Dashboard

d2i facilitates the use of data to drive operational improvement. It allows us to measure the effect of changes in operations and clinical care, empowering us to demonstrate the effects of these changes to administration.

Dr. Rick Rutherford, MD Quality Medical Director Seaside Emergency Associates October 21, 2017

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