Paula Dycaico, Director of Marketing at Quake Global 

Few people are lucky enough to avoid a visit to a hospital Emergency Department in their lifetime, either as a patient or with a loved one needing urgent care. In a recent informal survey in the Quake Global office, we found that 89% of our employees had been to the emergency department and 64% of our employees had experienced a wait time of 4 hours or more. In 2014, the Centers for Disease Control and Prevention reported the average ED wait time was 30 minutes and the average time to treatment is 90 minutes.

Using the Medicare hospital compare website we found these statistics for our state:

• Out of 6 hospitals in our area, on average the wait time to see a healthcare professional was 45 minutes but wait times could continue after triage for patients who were considered less acute. 
• On average, wait times from arriving in the ER to admission was 6 ½ hours. 

The reasons for long waits in the ED are as complex as healthcare itself. People who come to the ED have a wide variety of conditions and complications that require careful management and thoughtful clinician triage. Seasonal illnesses like the flu can cause a large influx of people in waiting rooms. There can be geographic challenges as well. Hospital emergency departments in areas with dense populations can experience frequent overcrowding. According to AHRQ, nearly half of EDs report operating at or above capacity and 9 out of 10 hospitals report holding or “boarding” admitted patients in the ED while they await inpatient beds. Because of crowding, approximately 500,000 ambulances are diverted each year away from the closest hospital. ED crowding has been the subject of countless news articles, lawsuits, and research studies. ¹ 

Patients who are otherwise healthy can get frustrated with long wait times and leave without treatment. This can create revenue leakage, but more importantly, premature departures without needed treatment can result in adverse events for patients, which can lead to legal complications for the hospital. In addition, patient satisfaction is impacted when patients wait beyond what they feel is an acceptable time frame. The latest data from HCAHPS surveys indicate that 12% of the 4,447 hospital participants received negative assessments from their patient respondents regarding time spend waiting for treatment.²  Because patient satisfaction is tied to reimbursement, these scores can impact revenue.  

Patient flow problems in the ED are a symptom of process problems, both within the ED but also of a broader problem facility-wide. If the processes to discharge patients on the med/surg floor are not efficient the ED will have delays in admitting patients to a room. Solving patient flow problems across the facility can assist in more efficient patient flow in the ED.  

The 2012 AHRQ guidelines for improving patient flow, the need to address ED crowding is highlighted with these key challenges to quality of care:

ED Crowding:

• Compromises care quality
• Is costly
• Compromises community trust

The conclusion in the publication is that ED crowding can be mitigated by improving patient flow. ³

Using Quake Global's RFID to Solve Patient Flow

Solving patient flow in the ED starts by examining the entire hospital ecosystem using accurate data for baseline measurements. Understanding performance metrics before and after implementing process change is mandatory to drive process improvement and generate accurate measurements of success. Implementing a system-wide RFID enterprise visibility solution such as the one offered by Quake benefits all departments and replaces anecdotal opinion with objective data.  

Quakes solution with real-time visibility to patient populations, staffing and equipment availability is an important technology tool used for process improvement. Having accurate real-time visibility brings the power of objective data to process flow optimization and the results are improved delivery of care, patient safety, regulatory compliance, and increased patient satisfaction. For patients, the benefits are clear, in both reduced wait times and faster access to high-quality care. IDN level visibility can empower larger facilities to monitor multiple facilities' emergency departments to enable proactive planning and to distribute patients across the entire health system in order to more effectively balance traffic, acuity, and capacity.

The power of planning through accurate visibility and trend analysis

Using the data available in QHealth allows users to analyze trends for continuous process improvement based on accurate data. Visibility to process flows can lead to improvements that produce measurable results with a positive impact for the ED and across the entire hospital facility./span>

Contact Quake to see how we can help establish a baseline and optimize patient process flow for your facility.

Quake Global offers synchronized and simultaneous 360^o visibility to everything that matters in healthcare with comprehensive data analytics that drives meaningful operational transformation.

1. October 2011 AHRQ Publication No. 11(12)-0094 McHugh, M., Van Dyke, K., McClelland M., Moss D. Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals. (Prepared by the Health Research & Educational Trust, an affiliate of the American Hospital Association, under contract 290-200-600022, Task Order No. 6). AHRQ Publication No. 11(12)-0094. Rockville, MD: Agency for Healthcare Research and Quality; October 2011.
2. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS): October 2018 Public Report: January 2017 - December 2017 discharges. Joint Commission on Accreditation of Healthcare Organizations: Approved Standards Revisions Addressing Patient Flow Through the ED. Joint Commission Perspectives®
3. https://www.ahrq.gov/sites/default/files/publications/files/ptflowguide.pdf