Optimal Teams and Performance Feedback Drive Improvements in Processing Measures.

The ED at ProMedica Toledo Hospital, a Level I trauma facility in Toledo, OH, has been able to chart impressive metrics on patient processing measures year after year. Administrators credit an overhaul in their triage process, a comprehensive approach to providing staff with regular feedback on their performance, and a system that relies on optimally sized teams to deliver care. Department leaders are hoping to boost patient satisfaction scores with an initiative that will leverage champions, fresh metrics, and a new mission statement to highlight the importance of the patient experience. Hospital administrators report that the median door-to-bed time in the ED is 23 minutes, and the median bed-to-physician time is eight minutes. The median length of stay for all ED patients stands at 121 minutes, and hospital administrators note that the ED's leave-without-being-seen rate tends to hover beneath 1%, far below the naticnal average. The ED uses a zone system that can adjust from two to five zones, depending on patient volume. The charge nurse is responsible for assigning patients to specific zones for care.