ED | Triage | Capacity Management | ER | Bucket Brigade

Is a 30 Minute ED Service Guarantee Just a Marketing Gimmick?

Eccelys Makes it a Reality!

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Our Approach

Step 1: Set Direction

Step 2: Define the Problem

Step 3: Identify Root Causes

Step 4: Identify, Test, and Select
Solutions

Step 5: Implement Solutions

Step 6: Monitor Performance

This Job is Not for the Faint of Heart!

• Running day-to-day operations in
parallel with transformation
• Raising the expectations of public and
staff
• Anticipate losing staff—recognize
“good turnover”
• Under constant attack (ED staff,
hospital staff, Hospital Board
Members, Physicians, the public,
volunteers, family members)
• Exhausting (physically and mentally)
• A true ‘Step Change’ in performance

Example
__________________________
Step 2:Define the Problem

Triage

• Sign-in sheet was too long
(redundancy)
• Triage RN asking unnecessary
   questions (redundancy)
• Serial processing "The Bucket Brigade"
(redundancy)
• Incorrect utilization of professional
  staff
• No “sense of urgency” on the part of
   ED staff

Step 4:Identify, Test & Select Solutions

Triage Redesign

• “Rapid Cycle Testing”
• New sign-in sheet
• Registration staff in Triage
• Wireless Communication Devices
• ED staff monitor status board and “pull
vs. push patient phenomena”

Step 5:Implement Solutions

• Went from 36% “30 minutes or less door-to-
doc” time to 83% without adding any beds
or personnel—eliminated redundancies.