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White Plains Hospital streamlines the emergency department patient experience

Rising patient volume and emergency department overcrowding can harm efficiency, communication and the patient experience, and can lead to patient safety events and negative outcomes. White Plains Hospital implemented a comprehensive ED redesign to improve patient flow and efficiency in the ED while reducing length of stay.

The ED leadership team implemented four main change concepts:

  • Quick look team: Performs a brief assessment and enters key information into a software program on patient arrival. The patient is then assigned to the appropriate team.
  • Triage bypass: All patients presenting to the ED are brought directly to a care space for triage and registration to occur at the bedside.
  • Team-based care: A team of providers (physician, advanced practice provider, nurses and nursing techs) is assigned to a zone in the ED. The team works as one unit to improve communication.
  • Streaming of care: Sorts patients into different evaluation tracks — mid-track for patients requiring minimal resources and acute track for those with significant injuries or conditions requiring complex care. Each track has a defined role and dedicated process of care for its patients.

These process changes helped improve efficiency by getting patients to the care team quicker, sorting patients based on acuity and overall decreasing time spent in the department. The team used the Plan-Do-Study-Act method on a weekly basis to review efficiency data, which were then shared with staff.

Before the initiative, baseline data showed an average door-to-provider time of 22 minutes and a door-to-department time of 205 minutes. The door-to-provider time significantly improved from 2019 to 2020, with the 2020 average decreasing to 12 minutes. The door-to-department time fell from 197 minutes in 2019 to 175 minutes in 2020.

For more information, contact Dean Straff, MD, medical director, emergency department, at dstraff@wphospital.org or 914.681.1158.