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Emergency Department wait times are hard for patients and staff
It’s no secret that there are extreme pressures on healthcare resources, and many patients who need medical aid are heading to their local Emergency Department for diagnosis and treatment. As a result, patient wait times are soaring.
Despite this data, the CDC reports that Emergency Department visits were down in 2020[1]. That’s because patients were putting off medical care, resulting in greater chances for later sentinel events. Since Emergency Departments in local hospitals are a primary point of entry to the hospital, delaying care causes a ripple effect through the system.
Because of the high patient volumes that many Emergency Departments experience, the Emergency Department may be the clinical area that the public is most familiar with, thereby making it the de facto “public face” of the organization. When crowding leads to long wait times and a decreased ability to protect patient privacy and provide patient-centered care, the community’s trust and confidence in the organization may be compromised…Over the past several years, much effort has been devoted to investigating the sources of Emergency Department crowding and developing potential solutions.”
AHRQ.gov
Patients spending 90% of their time waiting for services
At a large academic Level One trauma center that processes more than 100,000 emergency department visits yearly, 90% of emergency department patients’ time is spent waiting. What are they waiting for? They’re waiting for an available exam room, or a nurse; waiting for the doctor; or waiting for tests; or waiting to be admitted or discharged.
Typically, patients aren’t aware of the reasons why they’re waiting. Because of long wait times and poor communication, the hospital’s emergency department reported the lowest patient satisfaction levels of any of the hospitals in their 35-hospital system. Emergency Department patients often complain that they don’t understand or know why they’re waiting for services.
Emergency Departments are trying to manage a large influx of clients. With the increase in numbers, hospitals have understandable concerns about care delivery and patient safety. They’re hiring Travel Nurses amid a critical Nursing shortage, and supply chain issues cause equipment delivery delays.
Nurse leaders need to make sure that temporary Nursing staff follow specific procedures for clinical care and “doing no harm.” Operational workflow systems often become secondary to the caregivers’ clinical responsibilities, and consequently those workflows suffer.
Dry erase boards aren’t the answer
The typical hospital Emergency Department uses dry erase boards in their exam rooms to communicate relevant information to the patient, family members, and care team. However, dry erase boards have many disadvantages. The care team is actually taking time out of their clinical role to gather the information from multiple systems and write it on the board in the exam room. Nurses, especially new or traveling Nurses, often don’t have the time to complete dry erase board information.
Patient safety should come first
When and if patient information is actually completed on a dry erase board, the information becomes outdated, misinterpreted or irrelevant. This poses an obvious risk to patient safety, not to mention creating patient satisfaction issues, and hence, lower HCAHPS scoring.
Technology to help explain wait times and increase patient safety
There’s technology available to help ease concerns of patients as they wait in an Emergency Department exam room. By integrating a smart platform with existing systems in the hospital, like the EHR, nurse call, RTLS, and lab system, Nurses edit data at the whiteboard level. To automate the process, the new information updates back to the EHR.
Show a variety of information to ease patient worries about wait times, including risk protocols, admission information and discharge procedures. In addition, use the digital whiteboard with telehealth to speed consults and observe patients to lower wait times. Then care team members have visual cues to update patient data quickly and accurately on the digital whiteboards.
Test status and consults
Display test and consult status to patients using MediaCare, and show what tests or consults are in the queue. A digital whiteboard displays what consults the Emergency Department is waiting for, and helps patients understand that they’re “in the queue” for results or consults.
Telehealth
Using the video capabilities of digital whiteboards, patients with non-life-threatening conditions can be processed and procedures can be determined more quickly. From the digital whiteboard, Nurses can start telehealth visits from the patient room to speed up services and increase throughput.
“Adoption of the virtual care platform works best when there’s a surge in demand or a shortage of supplies, because it leads to a larger reduction in ER length of stay when those factors are present…new research in the INFORMS journal Information Systems Research finds that wider use of telehealth in the emergency room can yield positive results for both patients and providers” – Jeff Lagasse in Healthcare Finance
Observational video monitoring
When health systems need to monitor a group of patients, for example, to monitor them for movement or behavior disorders, a digital whiteboard at a Nurses’ Station can be used with live video to watch any number of rooms or beds. Observational monitoring can increase response time and help the care team accurately observe and record patient issues. That helps with staffing, since the Emergency Department can provide observation without posting a “sitter”. Since time is precious in the Emergency Department, that frees up staff time.
By automating the processes associated with their intake, care and treatment, it’s possible to change a patient’s impression of how long they’re waiting in the Emergency Department. Technologies like digital whiteboards and video boost patient satisfaction, and that in turn helps increase CMS and insurance reimbursements. Care Teams can optimize workflows by using a smart healthcare platform and digital whiteboards, thus eliminating outdated and time-consuming dry erase boards. Video conferencing speeds patient processing, and consult display helps patients understand why they’re waiting.
Learn about HCI’s platform to reduce patient wait times in the Emergency Department.
[1] Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 Pandemic on Emergency Department Visits — United States, January1, 2019–May 30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:699–704. DOI: http://dx.doi.org/10.15585/mmwr.mm6923e1external icon