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February 5th, 2016

Reducing patient wait time and improving staff satisfaction in the Emergency Department

By Elizabeth Zimmermann Young

 ED-CELL_VT3409990v10-7Emergency Department Clinical Engineering Learning Laboratory: Engineering better experiences for Emergency Department patients, employees

“I saw 21 patients today, and it’s now 5 p.m. There are only seven in the waiting room, despite an afternoon that saw peak registrations of 21 per hour,” said Eric Boie, M.D., Emergency Medicine, one recent Monday evening. “I can’t help but think what this Monday would have looked like before [the Emergency Department Clinical Engineering Learning Laboratory]. Clearly ... [there would be] patients waiting and many leaving without being seen.”

Health Care Systems Engineering is one of the programs in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. One of the program’s premier initiatives is the Clinical Engineering Learning Laboratory, a union of forces between a clinical department and the Kern Center. The first Clinical Engineering Learning Laboratory was set up as a collaborative, continuous research and quality improvement initiative in the Emergency Department.

ED-CELL_VT3409990v10-11Over the past year or two, visitors to the Emergency Department at Mayo Clinic Hospital — Rochester, Saint Marys Campus, may have noticed various changes. These changes have been implemented to decrease patient waiting times, enhance provider satisfaction, and improve the quality of care.

Redesigning the physical space — a project Dr. Boie helped lead — was the first step to higher quality service. To fully implement the learning laboratory concept, Kern Center engineers embedded themselves with Emergency Department employees in daily operations.

In addition to purposeful observation, real-time location system, and other ED-CELL_VT3409990v10-6data collection and analysis tools and technology were integrated. Together, practice and engineering teams are trying to make a learning and adaptable Emergency Department — with smarter, not harder, streamlined work processes. They’re transforming the practice and beginning to demonstrate success.

The project Dr. Boie referred to involves smart staffing:  identifying patient demand patterns and then matching ideal staffing levels (across disciplines) by day and time. Led by Mustafa Sir, Ph.D., from the center, and David Nestler, M.D., together with Michael Laughlin Jr., M.D., both from the Department of Emergency Medicine; and Emergency Department Clinical Engineering Learning Laboratory leads Kalyan Pasupathy, Ph.D., and Thomas Hellmich, M.D., this project could decrease physician burnout, reduce costs and improve the patient experience.

On other fronts, a real-time location system using radio frequency identification technology allows quick location of equipment, patients and providers. This technology already has enabled more efficient workflow, and the continuous learning process is expected to continue. The team also is studying patient pathways and ways to mitigate cognitive workload interruptions.

“Thanks [to the Emergency Department Clinical Engineering Laboratory] for all your work,” said Dr. Boie. “Patients are getting more timely care. I feel valuable as a provider. The evening and night are likely to be better for all — patients and providers alike.”

Tags: About, Center for the Science of Health Care Delivery, ED CELL, emergency department, health care systems engineering, Innovations, Kern Center, learning laboratory, living lab, process improvement, Science of health care delivery, smart staffing

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