Infection Control - St. Joseph Medical Center

EMergency Care
Faster ER Care, Thanks
to Auto Industry Methods
Treatment time decreased by 25%
When you rush a family
member to your neighborhood
emergency department, the first
thought that crosses your mind
is how long of a wait you’ll have.
According to Press Ganey Associates,
the average wait in a U.S. emergency
department (ED) is 3.7 hours. And
between 1996 and 2006, 32 percent more
Americans sought ED care. This has led to
a troubling situation—when an ED reaches
capacity, ambulances get diverted away
to distant EDs. To try to ease ED crowding,
many hospitals have scrambled to open
up more beds, but that doesn’t really help,
explained Durenda Juergensen, RN, assistant
vice president of Nursing Operations
at St. Joseph. “Opening up additional
expensive capacity isn’t the solution.
We need to attack the root cause of the
patient backups in the ED—the length of
time it takes to treat each patient.”
So, St. Joseph Medical Center forged
ahead with innovations—and succeeded.
“We’ve had a 25 percent decrease in
length of stay in the ED,” said Dr. Gail
Cunningham, chief of St. Joseph’s ED.
“The impact has been dramatic. By
reducing our ambulance divert times,
we are accommodating ambulances
and patients better, and have sped up
treatment time. Our yellow ambulance
diverts are down approximately 60 percent
and red diverts (critical care situations)
are down 85 percent.”
The road to success was to utilize
so-called “lean methods” from the auto
industry. To do this, St. Joseph recruited
an expert from that field; Dave Norton,
nicknamed “The Lean Guy.”
“Lean creates speed, by improving cycle
time, and efficiency, through elimination
of waste. We improved patient flow, eliminated
delays, standardized process steps
to ensure they are done perfectly, and
organized our workplace effectively,” said
Norton. “For example, we improved chest
pain patients’ time from arrival to an EKG
‰ When to go to the ER *
• Chest pain lasting more than
two minutes
• Uncontrolled bleeding
• Severe or sudden pain
• Coughing or vomiting blood
• Difficulty breathing, shortness of breath
• Sudden dizziness, weakness,
change in vision
• Severe/persistent vomiting or diarrhea
• Change in mental status
Do not delay—call 911!
*According to the American College of Emergency Physicians
by 50 percent. Patients get to key treatments
and decision points faster.”
“St. Joseph’s capabilities are vitally
important to the community’s health.
Being a major provider of emergency
services, including heart and stroke, we
still provide the highest quality of care
—but faster than before,” said Jurgensen.
Lean time-savers include:
• ED zone/room and staff are readied before an ambulance arrives
• Patient moves quickly into triage station where nurse and technician are both located
• A tracking system proactively reports patients’ test and lab data
SJMcmd.org / St. Joseph Medical Center Fall 2009