Urgent Matters E-Newsletter
Volume 6, Issue 2
November/December 2009
Special Focus Issue- Patient Intake
Focus on Urgent Matters Learning Network II
Hahnemann University Hospital
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Location: Philadelphia, PA.
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Number of Emergency Department Visits Annually: Approximately 40,000
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Number of Beds: 540 licensed beds
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Ownership: Investor Owned, For Profit
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Teaching Status: Yes
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Hahnemann University Hospital is an academic medical center that provides tertiary care to the City of Philadelphia and its surrounding counties. As a busy hospital located in a densely populated region of the country, Hahnemann was seeking to improve patient care by decreasing emergency department throughput times. This initiative was the driving force behind the organization’s participation in Urgent Matters Learning Network II. Hahnemann was also eager to learn how other hospitals were addressing emergency department crowding and patient flow issues. “We wanted to learn about what has been successful and what has not” said Mary Kay Silverman, RN, CEN, Director of Emergency Services.
Sustainable changes can only be made if the organization’s senior leadership is dedicated and supportive. Hahnemann’s leadership has been involved in the development and implementation of Urgent Matters strategies. Plans and results have been discussed at the highest level and leaders are informed and involved in all aspects of the project. In order to ensure sustainability, Hahnemann created an Urgent Matters team that truly represented the organization. By establishing a multi-disciplinary team of health professionals that includes physicians, registered nurses, nurse practitioners, and emergency room technicians, the organization has been able to generate interest in the project across the Emergency Department, and cultivate champions and informal leaders.
As part of Urgent Matters, Hahnemann University Hospital has implemented a number of strategies that directly impact patient flow in the emergency department. Hahnemann adopted the 5-level ESI triage system in August of 2009, and has been working to ensure consistency and establish standards in the way patients are triaged. Using the ESI system, Hahnemann has been able to observe and track the increase of level 4 and 5 patients and closely monitor the status of level 3 patients. This would not have been possible under the old triage system. Hahnemann is also using peer chart reviews to ensure compliance with the new triage policies. In addition, the Hahnemann team is working to develop a comprehensive fast track program and training curriculum about ESI triage for new hires in the Emergency Department.
Mary Kay Silverman has been using a number of techniques to keep her team motivated throughout the implementation of the Urgent Matters strategies. Hahnemann’s left-without-being-seen rates have been dropping consistently since the implementation of the Urgent Matters strategies. By communicating the success of the new processes, staff can see in real time how the strategies are working. Silverman gets feedback from her staff on a regular basis to keep them involved in the process and to address any issues related to the implementation.
Hahnemann University Hospital is dedicated to providing patient-centered care, and continues to take a multidisciplinary approach to combat patient flow problems. The Hahnemann team will continue collaborating with other hospital departments to come up with new and innovative ideas to address these issues.
