Emergency department patient flow issues have reached a tipping point. Here are four ways health IT can help.
What Makes Emergency Department Patient Flow So Challenging?
Emergency Departments (EDs) are one of the most challenging areas of any hospital to manage: High volumes of patients, often without enough clinical staff to care for them in a timely manner. The most critical cases need to be prioritized, without upsetting other waiting patients. Necessary equipment and care team members need to be located quickly, when they are needed most.
Adding to those day-to-day frustrations, overcrowding is even leading to increased violence, according to a report released in August by the Betsy Lehman Center for Patient Safety. The report, from an expert panel of Massachusetts emergency department physicians, nurses and patients, offers recommendations to aid and bolster safety improvement efforts in EDs, with particular focus on three areas of risk: crowding, cognitive overload and post-ED care coordination.
While the recent report focuses on Massachusetts, nationwide nearly half of emergency physicians report they have been physically assaulted at work, and more than half said that patients have been physically harmed. Further, 27% of emergency physicians said that assaults occurred more than once.
Clearly, we have reached a tipping point with ED overflow problems. But there are steps that hospital systems are taking to be prepared for an onslaught of ED cases, as well as help alleviate the stress and burden placed on patients, physicians and staff.
Addressing Emergency Department Patient Flow Issues with Health IT
Using health information technology, such as a real-time location system (RTLS) integrated with artificial intelligence (AI), data analytics and provider mobile communication, can help with that process in four ways:
- Efficient triage
- Predicting patient flow
- Improving communication and
- Reducing providers’ cognitive load.
A complete ED patient flow platform offers the insight providers need to deliver high-quality care efficiently and keep patients informed, cared for and satisfied.
1. Efficient triage
Avoiding overcrowding begins the moment the patient enters the ED.
The arriving patient can be outfitted with a wristband embedded with a radio-frequency identification (RFID) tag that is wirelessly tracked by the hospital’s RTLS. That first step is essential because from the second that wristband is assigned to that patient, hospital staff will know in real-time where the patient is and how long he or she has been waiting, both of which can help anticipate patient flow problem and the potential for crowding.
The patient’s location and time spent in each area are captured automatically through the RTLS instead of requiring a provider to enter the information.
The timeliness of information helps providers recognize the patients who have truly been waiting the longest so resources can be deployed to move the patient through the care episode.
This can help prevent overcrowding, but also improve patient satisfaction, which is a key performance outcome tracked by ED hospitals nationwide.
2. Predicting patient flow
Patient location and wait time information is only a small portion of the insight that is available with an ED patient flow system that is powered by AI and analytics.
With such a system, RFID data is combined with patient clinical data along with numerous data points from throughout the ED and fed through algorithms to develop real-time patient flow predictions about departmental wait times, as well as wait times in exam rooms or bays. Such AI-powered intelligence can also help the hospital estimate needed staffing levels and overtime, the number of additional beds required and equipment levels.
The longer the AI is used in the ED, the more accurate the predictions become due to the bevy of historical data available for analysis, which supports clinical decisions at the point of care.
For example, the ED patient flow system would offer estimates on how long a lab test would take, how long before an MRI could be performed, how long before a prescription can be delivered to the ED, which equipment is needed and many others. Since these patient flow engines are geared towards real-time predictions and results, these tools can be used on a continuous basis and not just as a periodic or retrospective exercise.
3. Improving provider communication
With patients in numerous locations and providers in constant motion, communication in the ED can be a challenge. That is why mobile devices have become a mainstay within the ED. By 2022, a report estimates that 97% of bedside nurses and 98% of physicians will use mobile devices for patient care, particularly for care team communication.
With an integrated ED patient flow system, providers receive automated alerts and critical information directly to their own smartphone or hospital-owned mobile device to support urgent clinical decisions and inform actions so that patients can efficiently receive needed care. For example, providers can know when a patient is leaving a pre-defined area or receive alerts for extensive wait times within a particular care sequence.
Messages to the care teams can also be customized, if needed, so if a provider assesses that a patient is becoming agitated or is at risk for aggressive behavior, security and support staff can be alerted simultaneously and in less time.
Thanks to the RFID tags, providers can also search for needed equipment directly from their mobile device and communicate with the care team about the location.
4. Reducing provider cognitive load
Cognitive overload has been attributed as the cause in 80% of medical device user errors.
An integrated ED patient flow system can reduce those risks by automating data capture, communication and more efficiently moving patients through the department. With the RTLS capturing patient location and time spent in each phase of care, it alleviates providers from having to search for patients, finding out how long they’ve been waiting and then manually entering their information.
Similarly, automated alerts and communication eliminate the burden of having to manually create and send text messages to the care team.
An integrated patient flow system in the ED makes improving performance easier, too, due to dashboards and easy-to-create reports of key performance indicators, such as:
- Bed, room and nurse turnover
- Patient wait times
- Average length of stay
- Patient and staff interactions such as arrival-to-registration, room-to-doctor
- Time to treatment metrics for emergent conditions such as stroke, STEMI and sepsis
Even less-often considered metrics such as how many times a provider entered and exited a patient’s room can be tracked and reported. While it may seem insignificant to providers, patients may be annoyed that their provider kept leaving during their encounter, lowering their overall satisfaction with the care experience.
An integrated ED patient flow system powered with AI and analytics enables organizations to discover correlations between provider workflows and patient satisfaction that may be eye-opening to administrators and providers.
Making sense of all the people and data in constant motion in the ED is complex and time-consuming. Health systems typically do not have the staffing resources to constantly monitor and record the location of patients, providers and equipment, along with their other patient care or administrative duties. An integrated ED patient flow system, however, can make such department-wide, 24/7 oversight possible, enabling the hospital to identify and route patients, assets and staff and access and communicate critical workflow data from any mobile device with greater automation and in much less time.
Ready to Learn More About How to Address Emergency Department Patient Flow Issues with Health IT?
By moving information and patients seamlessly through the ED, organizations can improve bed or room turnover, reduce wait time and help their providers work more efficiently by alleviating their administrative burden. Above all, these orchestrated ED workflows can help increase patient satisfaction and improve their outcomes, which are the primary goals of any healthcare organization.
We invite you to learn more.
TAGNOS is the future of clinical automation software solutions with Artificial Intelligence. TAGNOS is the only platform offering predictive analytics utilizing machine learning and RTLS. This groundbreaking platform leverages historical patient data continuously and adjusts operational intelligence to provide sustainable improvement to both the patient experience and metrics.
TAGNOS provides clinical systems integration, customizable reporting, dashboards, alerts, critical communication with staff and family to improve turnaround times. TAGNOS supports patient flow, workflow orchestration, and asset management.
In the course of 13 months, hospitals see a 12.7% reduction in its overall cycle time - saving an average of 40 minutes from each case and over $1.6M per year - more than 11x the typical investment.