Improving door-to-physician times in 2 community hospital emergency departments

Am J Med Qual. 2011 Mar-Apr;26(2):138-44. doi: 10.1177/1062860610379630. Epub 2011 Jan 6.

Abstract

Door-to-physician time in the emergency department (ED) correlates with patient satisfaction and clinical quality and outcomes. Delays in seeing a provider result in a 3% nationwide rate of patients leaving without being seen (LWBS) after presenting for ED care. Two community hospitals had door-to-physician times of 51 and 47 minutes. The LWBS rates were 3% and 2%. A quality improvement project was initiated with a change package, including prompts, training, and feedback. Door-to-physician times decreased to 31 and 27 minutes. The change occurred in less than a month and was sustained for 6 months after the study. In addition, the LWBS rates at each facility fell by one third. Basic process improvement strategies borrowed from service industries were used in 2 EDs to improve the door-to-physician process.

Publication types

  • Multicenter Study

MeSH terms

  • Appointments and Schedules*
  • Cues
  • Efficiency, Organizational*
  • Emergency Service, Hospital / organization & administration*
  • Hospitals, Community
  • Humans
  • Inservice Training
  • Management Information Systems*
  • Prospective Studies
  • Quality Improvement
  • Reminder Systems
  • Safety Management
  • Time Factors
  • Triage
  • Utah
  • Workflow*