Redesigning emergency department care delivery focusing on patient safety

Session
Emergency services

Authors
Twila Burdick
Vice President
Organizational Performance
Banner Health

Jeffery Cochran
Professor of Industrial Engineering
Arizona State University

Chris Modena
System ED Project Manager
Banner Health

Kevin Roche
Doctoral Student in Engineering
Arizona State University

Steve Kisiel
Regional Manager, Management Engineering
Banner Health

Abstract
Long waits, backups, and care delivery delays in hospital EDs put patients at risk. Nearly every ED within Banner Health has been facing similar challenges related to treating emergency patients in a timely, efficient, and safe manner. In response, Banner Health has completed a systemwide redesign of ED patient care delivery processes to reduce the time patients wait to see an ED physician.

The new design, consisting of 27 elements, was developed by teams of ED nurses and physicians. They worked in collaboration with Banner Health management engineers and Arizona State University industrial engineering experts, who provide analytical and educational resources for adapting the new ED model to the unique patient populations of each of the eight Banner hospitals involved in this program.

Implementation is overseen by systemwide leaders who monitor the progress of the implementation using a gap analysis as well as ED performance with an ED scorecard that provides ongoing comparative data. Over time, this information will provide the basis for making ongoing improvements to the design. Implementation of these significant changes is reinforced by being part of Banner's strategic initiatives that are reviewed quarterly by the board and included in its management incentives.