Driving Efficient Flow: Three Best-Practice Models

Abstract

J ust as establishing an airway is critical during resuscitation, efficient flow is paramount to achieving and sustaining service and operational excellence in the emergency department. Efficient patient flow is a key driver for quality, safety, and positive patient perception of care. It also ensures that ED providers consistently deliver quality clinical care to patients. When flow is inefficient, the opportunity to administer time-sensitive clinical processes and treatments for serious illnesses is lost. Treatment for acute myocardial infarctions (eg, reducing door-to-balloon time to b90 minutes), sepsis (early resuscitation, optimization, and antibiotic administration), and stroke (eg, pharmacologic and catheter-directed therapies for patients who are eligible) must be optimized. Unless an emergency department can optimize flow efficiency, it will continue to struggle in its performance, despite gains in other areas. In addition to the creation of important operational efficiencies, good flow reduces sentinel events and improves patient perception of care as wait times decrease. New data from the Centers for Medicare & Medicaid Services have given rise to greater pressure to improve flow in the emergency department. The following throughput metrics are now being collected and reported publicly at www.hospitalcompare.hhs.gov: