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EMCARE CONDUCTS LEAN RAPID REDESIGN WORKSHOP

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Higgins General Hospital
Bremen, Georgia
Annual E.D. visits: Over 20,000


Located in Bremen, GA, Higgins General Hospital is a 25-bed critical access hospital and has been a part of Tanner Health System since 1998.

Challenge. EmCare was asked to conduct a Lean rapid redesign workshop for the emergency department (E.D.) with the goal of improving operational efficiency. Expected outcomes included: streamlined patient flow, decreased throughput time, decreased left without being seen (LWBS) rate, improved patient and employee satisfaction and improved quality in delivery of care.

Solution. EmCare's Director of Clinical Services worked with the hospital's nurse leaders to reach the following goals for patient-centered care:

  • Create more organized patient flow
  • Minimize redundancy
  • Standardize the triage process

Specifically, the hospital worked to implement a bedside triage and registration process 100 percent of the time, with "pull 'til full" concepts implemented across all shifts and all staff in order to reach these targeted goals:

  • Arrival-to-provider time: 40 minutes
  • Bed-to-provider time: 25 minutes


Results. When healthcare professionals are able to effectively focus on patient-centered care, the result is improvement, not only in quality and the patient experience, but also in hospital performance. In this case, the department achieved significant metric improvements including (1) reducing the "arrival-to-provider" time by about 35 percent, (2) cutting the LWBS rate in half, and (3) moving from the 24th percentile to the 85th percentile in Press Ganey overall patient satisfaction scores. In addition, the hospital reduced its associated losses by about $25,000 per month.

The proof is in the results form January 2013 to April 2013:

  • Average E.D. Length of Stay improved from 177 minutes to 146 minutes
  • Arrival-to-provider time improved from 46 minutes to 30 minutes
  • Bed-to-Provider time improved from 10 minutes to 8 minutes
  • LWBS rate improved from 4.39% to 1.98%
  • Press Ganey Ranking (All) improved from 24% to 85%
  • Press Ganey Physician Ranking improved from 37% to 95%
EIS_HigginsGeneral_CaseStudy-1.jpg

Average E.D. Length of Stay:
Length-of-Stay.PNG
Improved from 177 minutes to 146 minutes.

Left Without Being Seen Rate:
LWBS.PNG
Decreased form 4.39% to 1.98%.

Press Ganey Ranking (All):
Press-Ganey.PNG
Improved from 24% to 85%.