Improve ED Flow With “Quick Hits” Meetings

    • February 27, 2013

Intervention Title:
Using “Quick Hits” Meetings to Solicit Continued ED Improvement Ideas

Result:
Avera reduced its emergency department (ED) decision-to-admit time to 32 minutes. This represented a decrease of 12 minutes per patient.

Institution:
Avera Marshall Regional Medical Center
300 South Bruce Street
Marshall, MN  56258

Profile:
Avera Marshall Regional Medical Center is a 25-bed full service hospital. Its Emergency Department (ED) typically sees about 600 patients monthly with approximately 100 monthly admissions.

Contact:
Erin Muck, RN
ER Manager, Trauma Coordinator, OB Manager (Interim)
(507) 537-9323
Erin.muck@avera.org

Innovation Implementation:
All emergency departments (EDs) struggle with reducing admission times for patients and moving them to inpatient beds efficiently. For many hospitals, the myriad problems that impact these issues are often recognizable to individual staff members but not always to the entire care team who has the opportunity to address them.  

As part of its commitment to continuous quality improvement in the ED, Avera Marshall Regional Medical Center implemented a new series of meetings known as ”quick hits” to solicit ideas and input into how to solve some of its most pressing problems. 

Topics for the “quick hits” meetings come from ED physicians who are solicited for ways to improve quality care, while reducing decision-to-admit time. Their ideas and information are then shared during regular ED staff meetings to engage all of ED staff in an open, problem-solving dialogue. The outcomes from these meetings are known as “quick hits” or quick improvements.

The “quick hits” meetings present an opportunity for all the staff to speak up and provide recommendations on how to improve practice, procedures and processes aimed at reducing throughput times. Through this process everyone’s ideas are listened to and valued while also building greater collegiality. Quick hits implemented by the group include:

  • If a patient’s chief complaint will likely warrant blood work, an IV is now automatically put in during the triage process and labs will be drawn. 
  • A goal time from when a patient presents to the end of triage was set for 10 minutes.
  • Patients are prepared for their MD exam and further testing as needed (put in a gown, prepped, etc.)
  • A triage process was created for when there are no beds in the ER to ensure that triage was done in a timely and safe manner. This also allowed the team to start testing and workups sooner.
  • A “stroke code” process was created and implemented to get stroke patients to the CT faster.
  • When orders are put in, the ancillary staff immediately receives a text to respond.  

Since starting the “quick hits,” process Avera has been able to quickly and continuously address operational issues. Patient care, job satisfaction and productivity have increased.