15th Annual Emergency Department Patient Flow Summit

15th Annual Emergency Department Patient Flow Summit
Held: November 2-3, 2016 in Houston, TX

The 15th Annual Emergency Department Patient Flow Summit convened hospital, health system, and industry experts to discuss best practices to enhance ED operational efficiency, enhance care coordination, and leverage data and technology to improve patient flow, patient satisfaction, and health outcomes.

View Original Brochure Agenda (PDF)

8 available session presentation slide decks (PDFs) included with purchase.

Session Topics Include:

Pre-Summit Workshop - Leverage Data to Drive Efficiency in ED Patient Flow
Part 1 (1 hr 30 min 2 sec)
Part 2 (1 hr 33 min 18 sec)

It’s no secret that data plays an integral and crucial role to diagnosing and solving patient flow challenges within the ED. However, while clinical teams and administrators in hospitals understand the need for data, the major questions still remain on what data metrics are important and how to most effectively utilize them to deliver improved outcomes, better patient experiences, and lower operating costs. In addition, ED administrators continue to grapple with the challenges of effectively communicating data-driven insights to clinical teams in order to drive evidence-based care. In this workshop, take a deep dive into data mining and utilization, and explore effective communication channels to improve patient flow.

  • Discuss traditional and emerging data metrics critical to understanding performance of the ED and patient flow, including:
    • Length of stay
    • Readmissions
    • LWBS
  • Examine the merits and opportunities for different data sources including EHRs, team input, and national surveys
  • Leverage both internal and external data performance benchmarking metrics to evaluate the efficiency of patient flow
  • Explore available technological tools to capture, analyze, and communicate data insights
  • Identify valuable partnership opportunities with both internal and external stakeholders

Carl Balcom, RN, BSN, MHA, CHE
Director, Emergency Services
Kingwood Medical Center - An HCA Affiliated Hospital

Jessica Thompson Melton, MHA
Vice President, Emergency Services and Patient Flow
Duke University Hospital

Chairperson's Welcome and Opening Remarks
(3 min 9 sec)

Improve Collaboration and Operational Efficiency to Achieve the Triple Aim
(57 min 50 sec)

When it comes to patient flow, change is inevitable. In order for hospitals to keep pace with their flow strategies, they must focus on operational efficiency. As we continue to strive toward the Triple Aim, patient flow strategies must also evolve beyond improving throughput and patient outcomes to incorporating initiatives that enhance patient experiences as individuals travel through the continuum of care. In order to be successful in 2016 and beyond, hospitals should leverage collaborations and effective communication between clinical teams to drive efficient patient throughput, maximize resource utilization, and reduce costs.

  • Develop roles in the ED to create a team environment that is structured to succeed in accomplishing the goals of patient care
  • Understand transactional versus transformational change and apply the best engagement strategy to your ED patient flow goals
  • Explore how one organization applied change management and positive deviance theory to its patient flow strategy to decease discharge order times and length of stay
  • Balance hospital-wide and unit-focused approaches to solve patient flow challenges
  • Evaluate emerging skill sets and tools critical to eliminating bottlenecks within the hospitals that lead to ED overcrowding

Eugene Chu, MD, FHM
Director, Hospital Medicine, Boulder Community Health
Associate Clinical Professor of Medicine, University of Colorado School of Medicine

Ensure Buy-in and Align Patient Flow Objectives Among Hospital Leadership and Care Teams
(32 min 6 sec)

Efficient patient flow is a result of effective collaborations between care teams and administrators. Care coordination within the hospital has never been more important as it helps to align priorities of care teams, reduce unnecessary variations, and minimize waste within the system. ED leadership must utilize opportunities to bring together care teams that include Hospitalists, Physicians, Nurses, Case Managers, Social Workers, and Ancillary departments such as Environmental Services, Lab, Radiology and Therapies. In this discussion, learn considerations and strategies to bring care teams together across the continuum of care.

  • Identify key players and develop effective methods to communicate throughput priorities to these different hospital stakeholders
  • Engage leadership in patient flow strategies to ensure buy-in and support
  • Leverage technology to communicate with care teams and reduce process variations
  • Discuss approaches to develop and maintain a culture of transparency, respect, and accountability among care teams
  • Learn how to measure your results to meet regulatory requirements
  • Develop strategies for community collaboration to engage outside resources such as patient placement and transportation

Genean Grant, MHA, BSN, RN, CCRN
Director, Emergency Services
Venice Regional Bayfront Health

Case Study: Discuss the Impact of the Nursing Shortage on ED Turnaround Times and How to Overcome It
(39 min)

Unstaffed beds create a major road block and unavoidable bottleneck for the ED. Predictive staffing, demand matching, creative scheduling, and PRN utilization can help maximize your nursing resources. In this case study, hear about one hospital’s journey to successfully reduce ED turnaround times, then suffer significant delays and diversion due to nurse staffing shortages, and how they are working to overcome it.

  • Review creative staffing and scheduling models in the ED and inpatient setting
  • Discuss how admissions department structure impacts placement and staffing
  • Examine how predictive staffing can be used to overcome perceived staffing shortages
  • Understand technology overlays that enhance the correlation of flow with staffing

Dancel Maxwell, BSN, MPA
Divisional Director, Clinical Patient Access and Cardiology
Good Shepherd Medical Center

Chairperson's Welcome and Review of Day One
(2 min 13 sec)

Case Study: Improve Patient Experience with a Better ED Patient Flow
(57 min 55 sec)

As consumer experience continues to drive industry trends in health care, hospitals are putting more focus on improved patient experiences within the ED. CMS recognizes that patient care in the Emergency Department is a critical predictor of overall patient experience. CMS has developed and is implementing the Emergency Department Patient Experiences with Care survey (EDPEC) sometimes referred to as EDCAPHS. EDPEC will provide patient experience data that enables the comparison of EDs across the country. The ED is considered the “front door” of the hospital and as such, can make or break the patient’s perception of the hospital. Patient throughput/flow has been directly linked with patients’ perception of their experience while in the Emergency Department. As reimbursements become more closely tied to patient experience, hospitals need to identify patient throughput as a top organizational priority. In this case study, see how innovative patient flow practices within the ED have resulted in improved efficiency, quality, and patient experience.

  • Discuss emerging ED workflow challenges and their impact on the patient experience, patient safety, and hospital bottom line
  • Understand the importance of executive buy-in of organizational throughput as a hospital-wide top priority
  • Explore innovative approaches that improve patient flow and patient perception such as the Pull ‘Till You’re Full strategy also known as Split Flow Model
  • Hear how one organization performed a Lean analysis to identify opportunities impacting both patient flow and patient experience resulting in improvements in wait times, length of stay, and patient experience scores
  • Provide simple tools for ED health care providers that improve a patient’s perception of care by removing perceived barriers

Angela Gary, MSN, MHA, BSN, RN, NEBC
Executive Director, Emergency Management Services
Chesapeake Regional Healthcare

Jude Kotsko, MD, FACEP
SME for ED Performance and Throughput, ED Physician

Integrate Behavioral Health to Improve Patient Flow and Reduce Readmissions
(41 min 32 sec)

There is a high incidence of avoidable readmissions of behavioral patients through Emergency Departments. Behavioral health patients who frequent Emergency Departments present a multitude of challenges for the ED including patient flow and financial and staffing burdens. These patients also tend to have worse health outcomes and lower quality of life. As EDs look forward to improving patient flow efficiency and quality, they should consider strategies to cater to the unique needs of behavioral health patients.

  • Explore the challenges of throughput for behavioral patients by examining how they fit in the ED workflow
  • Discuss the financial implications of treating patients with behavioral health needs in the ED
  • Dive deep into a community collaborative model for treating patients with behavioral health needs and understand its financial and operational impact on ED patient flow
  • Establish quality metrics and analyze data to determine the ROI of integrating behavioral health and its impact on patient flow

Susan Hawk
Acting Chief, Clinical Integration
Behavioral Health Institute Mercy Health

Karen W. Hogan, ND, RN, NE-BC
Director, Nursing Services
Mercy Health Youngstown Market

Case Study: Expand Your Split Flow Strategy to Create More Opportunities to Improve Patient Throughput
(44 min 21 sec)

As Emergency Departments continue to be the main health care access point for many, especially as more patients gain insurance coverage, optimizing patient throughput and delivering better experiences has become more critical than ever. Many EDs have adopted a Split Flow strategy to divide their patients based on 3 acuity levels: low, medium, and high. The medium acuity patients can be further split into vertical and horizontal patients which helps ED administrators maximize resource utilization by channeling the right amount of resources and clinical staff that meets the exact needs of the patient. In this case study, hear how one ED continues to reduce their length of stay by innovating within their Split Flow strategy beyond the 3 acuity level.

  • Evaluate the pros and cons of expanding Split Flow strategy to low and medium acuity patients
  • Consider the factors and rationale in expanding the Split Flow strategy
  • Dive deep into the Stanford Healthcare Split Flow initiative
  • Examine the keys to success including Lean strategy and a strong physician/nurse collaboration

Patrice Callagy, RN, MPA, MSN, CEN
Director, Emergency Services
Stanford Health Care

Sam Shen, MD, MBA, FACEP
Medical Director, Emergency Medicine
Stanford Health Care
Clinical Associate Professor Department of Emergency Medicine
Stanford University School of Medicine

Create Operational Margin to Find the Critical Final Pathway to all Throughput Solutions
(38 min 9 sec)

No operational margin means no patient flow regardless of which throughput solution one chooses. In this session, tease out the single common characteristic of all successful throughput solutions by demonstrating the concept of operational margin. Explore the elements of resource utilization and demand variance and how these factor into operational margin and ultimately impact an ED’s ability to create good patient flow.

  • Define “good” patient flow and what it means for the organization
  • Understand the concept of operational margin
  • Learn how resource utilization and variance work together to impact operational margin and patient flow
  • Examine how various identical patient flow solutions succeed or fail based on the concept of operational margin
  • Explore how creating operational margin can assure that you deliver on patient flow goals with 90% probability

Joseph Guarisco, MD
Department Chair, Emergency Medicine
Ochsner Health System

Case Study: Redistribute Physician and Nurse Workflow to Enhance ED Throughput, and Improve the Patient Education and Discharge Process
(51 min 23 sec)

Reducing ED throughput time is critical to improving patient perceptions and decreasing medical errors attributable to crowding and interruption. The majority of Emergency Department patients are treated and released as outpatients. At the time of discharge, patients often have questions and requests that physicians are best suited to address. Timely departures after a discharge disposition decision has been made improve the patient experience. In this case study, hear how redistributing workflow within the ED can improve ED throughput, strengthen patient education and efficacy, and improve patient satisfaction.

  • Create multi-disciplinary collaboration to shorten the discharge process
  • Hear how one safety net hospital improves resource allocation to enhance patient flow and perpetually create capacity

Janine Duran, RN, MS, APRN, CEN
Director, Nursing, Emergency Department
SBH Health System / St. Barnabas Hospital

Daniel Murphy, MD, MBA
Chairman, Department of Emergency Medicine
SBH Health System / St. Barnabas Hospital