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Improvement at Hamilton Medical Center Emergency Department

Jason Rodwell and Sheri Hicks - Intake Room

Things were simply taking too long to get done in the Emergency Department at Hamilton Medical Center. This was frustrating to both patients and staff. After completing a challenging construction project that had constrained our space we knew we must develop a smarter way to work. Jason Rodwell, our lead Physician Assistant, was a strong advocate of focusing the efforts of two Advanced Practice Clinicians on patients with minor emergencies. The idea was to care for these patients more efficiently and thereby decompress the department overall.

On July 26th 2016 representatives from TeamHealth hosted our department leaders on an off-site process improvement retreat. TeamHealth's Performance Improvement Consultants facilitated a planning session by our department leaders to develop an improvement plan. Over the course of four hours our front-line leaders elected to implement a major process change called "Split Flow". They selected a go-live date of August 11th 2016, just a little over two weeks away. They planned for our iteration of Split Flow to consist of two teams. Each team would include a Physician Assistant or Nurse Practioner, such as Jason Rodwell and an Emergency Nurse such as Sheri Hicks as pictured above. The teams would have a dedicated area with intake rooms, treatment rooms, and a results-waiting area. 

Results Waiting Area

On August 11th, our excellent front line staff went to work. Our Physician Assistants and Nurse Practitioners, led by Jason Rodwell, along with the Emergency Nurses, led by Clinical Managers Ashley Cloer, Angie Johnson, Karen Emard, and Mike Nichols addressed challenges as they arose and ironed out the kinks. The results have been truly outstanding and also sustained. After implementation, the amount of time it takes to see a medical provider decreased 55%. The amount of time those with minor emergencies spend in our department decreased 46%. For all patients discharged from our department the amount of time decreased by 20%. Since implementation we have also accommodated higher patient volumes and experienced improvement in our patient satisfaction scores.

As the Medical Director, it has been one of the greatest privileges of my career to watch this dedicated team of healthcare professionals implement and sustain an improvement of such magnitude on behalf of the patients we serve. 

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Wednesday, 18 July 2018

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