CHRISTUS Santa Rosa Hospital-Westover Hills
San Antonio, Texas
Annual E.D. visits: Over 65,000

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CHRISTUS Santa Rosa Hospital - Westover Hills is the first acute-care hospital in the Westover Hills community. The 150 bed hospital is located on a full-service health care campus with state-of-the-art technology and offers a full scope of specialized services.

Challenge. As part of the “Promise of Excellence” for CHRISTUS Santa Rosa Hospital Westover Hills, the hospital set a goal for its emergency department (E.D.) of implementing a “no wait E.D.” program, improving throughput metrics and shifting the culture to provide greater value through an intense focus on the patient. In order to succeed, the program required both commitment and education of the physicians and nursing staff. EmCare was up to the challenge. Led by the E.D. On-Site Medical Director (OSMD) and the E.D. Nurse Director, implementation began in October 2011.

Solution. The “no wait E.D.” program was piloted in November and went live in December 2011. With a goal of providing an excellent patient experience, efforts turned to decreasing E.D. wait times, reducing Left Without Being Seen (LWOBS) / Against Medical Advice (AMA) rates and improving value.

Overcoming obstacles and challenges, the department began to hit its stride by midyear 2012 decreasing wait times and improving flow. At the same time, the process had an underlying benefit of making the job of the physicians and nurses easier and more enjoyable. The program encouraged recognition and communication of positive feedback to the physicians and nurses as patients consistently returned high ratings for the care they received.

The department began outperforming goals as the physicians and staff continued to practice Studer principles learned in patient satisfaction workshops provided by EmCare. The training included an AIDET® Validation Lab, practicing key words at key times and consistent hourly rounding on patients. Strategies included:

  • Implementing a “pull `til full” E.D. algorithm
  • Goal setting and accountability
  • Improving rapport with senior leadership
  • Training on Studer Group principles
  • Daily metrics through the Standardized Timely Accountability Reporting and Recognition (STARR) report
  • Interactive validation lab with one-on-one coaching

Results. The strategies used at Westover Hills paid off with significant improvements in metrics and results:


 Left Without Being Seen Rates:
Dropped from 7 percent to 2.9 percent.

Arrival to Greet:
Improved from 77 minutes to 40 minutes.