Emergency Department staff members huddle together holding signs that say, “Thank you from PPMC ED [red heart]."

There are few things that Christopher Edwards, MD, chief of Emergency Medicine at PPMC, appreciates more than the sight of an empty waiting room in the Emergency Department (ED). This means that patients are being connected to the care they need when they need it, without long wait times or overcrowding. Following the successful rollout of the Presby EnhancED initiative, that sight has become more frequent over the past five months.

Presby EnhancED aims to tackle capacity challenges and improve the patient experience with an optimized triage process and a three-track flow model. By rapidly assessing patients when they arrive, then assigning them to either super track, mid track, or acute care designation, the team can treat and discharge patients with less acute needs more quickly and in a separate area, keeping the main ED available for more complex cases. This keeps everyone moving efficiently and prevents frustration.

Since the first phase of EnhancED went live, the team has already made significant strides towards their metric goals. The percentage of patients who leave without being seen or completing treatment during current operating hours has decreased to 3.3 percent (the goal is 3 percent), and the average door-to-provider time has reduced to 21 minutes (the goal is 20 minutes). Though the changes are currently only in effect Monday through Friday between 9 a.m. and 8 p.m., these early successes suggest that the team will be able to translate the changes to the evening shift during the second phase of the project.

“Who goes live with a new workflow in the middle of a pandemic?” Edwards said. “But the staff have been amazing. This has been a whole overhaul of the way that we process patients, and we have learned a lot from their feedback.” For example, COVID-19 revealed that a bigger footprint was required to care for acute patients, while a smaller footprint could accommodate super/mid track patients; this led to some adjustments to the staff in each area.

“There have been some growing pains,” he said, “but these changes have been possible because our nurses, techs, and staff want to create the best experience they can.”

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