Four years ago, Allen Medical Center, Oberlin, Ohio, came within two weeks of closing. The 25-bed, mostly outpatient critical-access facility had just brought in a new management team to focus its turnaround effort on the small, cluttered, attitudinally poisoned emergency room.
"We were seeing 10,000 patients a year there," says hospital President Edwin Oley. "Those 10,000 people were going back out into the community. That was becoming the perception of the hospital."
A $1 million grant from a local foundation took care of the brick-and-mortar issue, enabling Allen to build a 6,000-square-foot ER four times the size of the previous one-with a centralized nursing station and nine completely private treatment areas.
The 11th-hour work focused on a one-hour guarantee: If patients were not triaged within 15 minutes and seen within an hour, they would not be charged. The management team realized they had been seeing 95% of patients within a half-hour, anyway.
"We thought if we could guarantee that you could see a doctor in a short period of time, that would wow the market," Oley says. When the program began in February 2003, "Literally, within the first week of launching it, our visits in the ER increased by 30% and have never gone down."
In 2004, Allen expects year-end figures will hit about 14,000 visits, a 40% increase overall-and that has had hospitalwide effects, Oley says. Admissions are up 30%, computed tomography volumes rose 122% and rehabilitation services grew 61%. Net revenues attributable to the ER have jumped $1.6 million thanks to a program that cost $100,000, the hospital says. And 99.5% of ER patients were seen within the hour, contributing to Press Ganey Associates patient-satisfaction ratings above the 90th percentile for two years running. "You see that halo effect in the entire organization," says Susan Bowers, vice president of patient services. For these achievements, Allen has won the Spirit of Excellence service award.
The changes to achieve those results have been more process- than technology-driven, Bowers says, with patients who don't need immediate treatment being taken to a hospital admitting area and then escorted directly to their room-"not back to the waiting room. That significantly cut back the amount of time and that perception that, `Here I go, I have to sit back in the waiting room,' " she says.
The experience of working together and succeeding has significantly improved employee morale, Bowers says. "Everybody likes to work for a winner," she says. "That's been evident in the fact that we have no openings in our ER."
"They have proven results," says judge Janice McCoy. "They've been able to measure the outcomes and have some significant improvements to show for it."