Emergency Department Services
Improve Emergency Department Throughput and Patient Outcomes
Emergency care is one of the most important hospital services provided in rural communities. Emergency Departments (EDs) are the front door of your rural and community hospital and the window into how the community views your organization. Through the ED, your facility can have the opportunity to make or break a patient’s perception of their care. Stroudwater partners with hospitals to perform operations-based evaluations of ED throughput and EMTALA, transitions of care, and patient outcomes.
Through the Emergency Department, your facility can have the opportunity to make or break a patient’s perception of their care.
Emergency Department Throughput
Our team recognizes the crucial role that throughput plays in the efficient operation of an emergency department. We collaborate with rural and community hospitals to improve their ED throughput by evaluating their current practices and processes that impact workflow and efficiency. On site, we’ll evaluate your organization on a range of measures, and because we use an in-the-moment charette approach, we provide an actionable plan prior to leaving your hospital.
Our team evaluates the entire path of a patient visit from Registration to Admission, Discharge, or Transfer. This approach allows our team to assess compliance with regulatory standards, evaluate the implementation of policies and procedures, and identify potential gaps and areas for improvement.
Maintaining EMTALA Compliance
Research indicates that EMTALA violations occur at an annual rate of 4%–5%, with most violations happening in high-volume emergency departments. Even a single EMTALA violation can result in significant financial repercussions for facilities and providers. Our clinical and quality team partners with your organization to assess and enhance your compliance with EMTALA regulations.
Together with your team, we will:
- Ensure all staff members are educated and trained on EMTALA
- Develop, review and revise EMTALA-related policies and procedures than thoroughly train all staff on those procedures
- Develop a process to ensure new hires receive EMTALA training at orientation and annually
- Assess ED patient log and make sure it contains all necessary information concerning disposition
- Ensure EMTALA signage is visible and appropriate in language and location
- Review the provider on-call list to ensure it includes appropriate information
- Evaluate the ED transfer log and physician certifications
- Audit medical records of patients who transferred, left AMA, LWBS, or had a long arrival to MSE time and provide education when concerns are identified
- Arrange for a mock EMTALA survey that includes record reviews and interviews
Findings from the field
Every patient that leaves a hospital’s ED without being seen is a patient safety concern that may negatively impact the reputation of the organization due to patient dissatisfaction and could lead to potential loss of revenue. It is important to consider the number of interdependent and possible downstream areas ED visits impact.
These may include, but are not limited to:
Acute Development of Swing Bed Services
Observation Status
Respiratory Services
Laboratory Tests
Radiology Exams
Referrals to Primary Care and Other Specialists
A lost ED visit is not just a visit lost, it is the loss of a relationship with a patient — and maybe a family — with potential long-lasting effects on our organizations and the communities we serve.
Improving outcomes for behavioral health
patients in the emergency department
In recent years, there has been a surge in patients presenting to emergency departments with behavioral health conditions, often with co-occurring issues. This trend is creating a crisis for rural EDs, which often lack access to behavioral health specialists and/or available beds within nearby psychiatric hospitals or treatment centers.
Our team helps rural and community hospitals improve outcomes for behavioral health patients, reduce lengths of stays, and address the increase in workplace violence against staff and clinicians in the ED. Building on evidence-based best practices and developed in partnership with national experts, our approach features strategies for:
Our Approach to Care:
- Engage cohorts of 6-12 rural hospital teams over a 12-week “sprint”
- Teams set a specific and measurable goal at the beginning of the program and engage in weekly 60-minute webinars led by the content experts.
- Between each weekly webinar, teams test new ideas for improvement and track their progress with a small set of measures.
The Emergency Department Services Team
Connect with the team
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