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How Colo. hospital reinvented its ED

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University of Colorado Hospital, in Aurora.


The University 0f Colorado Hospital reinvented its emergency department to cut wait times and costs, writes Richard Zane, M.D., who runs the department.
While some hospitals have seen the challenge as making small emergency rooms big ones, Dr. Zane, in the Harvard Business Review, noted that:

“Instead of being small, crowded and dysfunctional, many EDs are now big, crowded and dysfunctional. That’s not progress.”

So, his article says, his hospital created groups of 8-10 providers to quickly study quality, operations and process improvement. A nurse and a physician led two of the three groups, and an engineer, a nurse and a physician led the process-improvement group. Members rotated among the subcommittees.

The groups decided to:

  • Improve the patient experience by eliminating triage and having a senior physician see each patient within minutes of  a patient’s arrival.
  •  The hospital moved the ED observation unit when it became clear the location didn’t work, and moved portable X-ray machines to certain non-critical patients rather than moving them to the machines.
  • Develop  care pathways for high-risk presentations, including heart attack, stroke and sepsis, or those associated with significant practice variability, such as chest, abdominal and back pain. Thus  the ED was able to cut high-cost imagery costs by 15 percent and avoidable hospital admissions by 20 percent.

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