ED Wait Time & System Transformation
Issue
A large community hospital was challenged with its ED wait times, performing at an average level compared to other provincial hospitals (40th out of 73 hospitals), while it aspired to do better. Despite rigorous efforts over the years and investment in continuous improvement and innovative solutions, the small incremental advances were not keeping up with the growing challenges facing the hospital and the system. The consistent patient flow challenges and lack of progress also took a toll on the health and well-being of staff and physicians, who struggled to feel fulfilled in their roles as they watched their patients wait and languish.
Approach
We worked with the hospital leadership and key stakeholders to devise and implement a long-term strategy utilizing a customized change management framework and lean principles to address the challenge at the hospital and system level. Through an 18-month journey, we were able to deliver significant improvements across all dimensions of care including access, patient experience, staff wellbeing and operational efficiency. More importantly, the transformation is culture and strengthening of internal and external relationships positioned it effectively to deal with the COVID challenges that followed a year later, which tested leaders’ ability to work together across the system to manage care and flow of patients and community members.
Result
The hospital’s provincial rank for Emergency Department wait times drastically improved from 40th to top 5.
The hospital’s Emergency Department wait time was reduced:
Avg Time to Inpatient Bed from 7.9 hours to 2.8 hours.
90th percentile Time to Inpatient Bed from 20.3 hours to 5.5 hours.
The facility’s Alternate Level of Care (ALC) dropped to 13% from 25%.
Staff wellbeing increased by 27%, and Trust in leadership increased by 30%.
