Improving Emergency Department Performance Through Simultaneous Operational and Cultural Enhancements

Area of Science:

• Emergency Medicine
• Healthcare Management
• Process Improvement

Background:

• Emergency departments (EDs) face scrutiny for efficiency.
• Process improvement initiatives often lack comprehensive redesign.
• A novel model was developed to address ED performance and patient experience.

Purpose of the Study:

• To determine if a design-thinking-based model improves patient experience and flow metrics in multiple EDs.
• To evaluate the impact of a comprehensive program redesign versus individual projects.

Main Methods:

• A multi-faceted PEOPLE+ model was implemented across 7 EDs.
• The model focused on philosophy, economics, operations, providers, and leadership.
• Key performance metrics were compared pre- and post-implementation over 22-24 months.

Main Results:

• Statistically significant improvements were observed in reduced Left Without Being Seen (LWBS) rates, diversion hours, and length of stay (LOS).
• Patient experience scores and door-to-provider times showed substantial positive changes.
• Sustained improvements were noted across multiple metrics in subsequent 6-month intervals post-implementation.

Conclusions:

• The PEOPLE+ model, emphasizing provider ownership and involvement, significantly enhanced ED performance.
• Changes in operational, leadership, and staffing models drove measurable improvements.
• A holistic, design-thinking approach is effective for comprehensive ED redesign.