A set of standard protocols for common patient complaints has enabled the emergency department at San Antonio Community Hospital to greatly improve its patient-satisfaction scores while reducing wait times, earning the 283-bed facility a Spirit of Excellence service honorable mention.
A new and more accurate electronic records system revealed the extent of wait times at the Upland, Calif., facility, which was built to handle 30,000 patients per year in 1973, but saw some 65,000 people during 2003.
"We thought, why can't we use the (patients') wait time to our advantage?" says Steve Ernst, who is the medical director for the emergency department. "Why don't we come up with some pathways or protocols to get the patients started?"
The department instituted pathways for conditions such as abdominal pain, congestive heart failure and shortness of breath, and has since expanded to 14 tracks that account for more than half of its patients, says Debbie Poore, nursing director for the emergency department. Not everyone on staff immediately bought in to the concept, she says. "We had to have some champions on the floor."
During the past two years, the facility's left-without-being-seen rate has dropped to 2.4% from 4.2%; patient satisfaction has improved to the 84th percentile from the 33rd; door-to-triage time has dropped to 18 minutes from 30; door-to-treatment time has fallen to 40 minutes from 111; and wait times for patient beds decreased to 21/2 hours from 4 hours.