The emergency department (ED) at Children's Hospital Central California has experienced rapid growth, with annual patient visits climbing from 55,000 five years ago to over 70,000 during our fiscal year ending Sept. 30. This remarkable 27 percent increase in patient volume extended the length of time families waited to receive care.
“Open beds, empty triage” reduces wait
To help manage growth, Children’s Hospital recently opened our ED expansion of 11 state-of-the-art rooms and engaged outside consulting services to guide us in improving our care delivery. As a result, we established our new “open beds, empty triage” policy to ensure patients no longer undergo a lengthy triage process. Newly arriving patients are taken directly to an open room when available. The same nurse assigned to care for the patient during the family’s ED stay also performs triage. Our “open beds, empty triage” policy frees parents from repeating the patient’s history to as many as three different caregivers. This process alone cut more than 30 minutes from the typical wait between first entering the ED and seeing a physician.
“Team triage” increases patient satisfaction
Children's Hospital Central California implemented another timesaving improvement with our “team triage” station, open from 3 p.m. to 1 a.m. This six-bed pod, staffed by a pediatric emergency physician, two nurses and a nursing assistant, opens the door for patients to see a physician upon arrival to the ED. Simple cases can be discharged directly from team triage. In other cases, the team can begin laboratory tests and imaging procedures even before patients are taken to an ED room. This streamlined process has greatly increased patient and family satisfaction by reducing their stay in the ED by over an hour.
ED enhancements make measurable difference
The “open beds, empty triage” policy and the “team triage” process in our newly expanded ED have led to amazing results:
Average time from arrival to seeing an ED physician – 24 minutes
Average time discharged patients spend in the ED – 122 minutes
Both statistics represent a vast improvement from previous numbers and surpass national standards. The rate patients leave without treatment (LWOT) plunged to 0.4 percent, compared to the national LWOT rate of 2 percent. Implementing these changes has helped transform our Press-Ganey patient satisfaction scores, propelling our ED from the 10th percentile to the 91st percentile in six short months.
Pediatric experts provide specialized care
Staffed by board certified pediatric emergency physicians, the ED at Children's Hospital Central California is the best place for ill and injured children to receive treatment. In addition to their years of experience providing pediatric emergency care, our emergency specialists have undergone three years of general pediatric training plus an additional two to three years of fellowship training in pediatric emergency medicine.
Pediatric emergency physicians tend to order fewer blood tests and radiographs than general emergency departments. Our experts understand pediatric diseases and remain up-to-date on current treatment protocols and research.
Together, the newly expanded ED, the successful implementation of timesaving policies and procedures, and the team of medical professionals at Children's Hospital Central California have greatly improved our patients’ access to quality pediatric healthcare. Our next step on the road to improvement is to engage the same consultants to assist us in enhancing our processes with regard to fluctuating inpatient staffing needs.
“We had to drive an hour to get to Children’s,” wrote one satisfied parent. “But, the care was much faster than our local ER. The doctors and nurses were amazing and took great care of our child. We would never go anywhere else!”