Urgent Matters was a national program of the Robert Wood Johnson Foundation (RWJF) that aimed to relieve emergency department overcrowding, improve patient care and increase patient satisfaction.

The program also sought to use the example of emergency departments to help communities understand the interdependence between the health care safety net—of which emergency departments are a key component—and the rest of the health care delivery system.

The program operated in two phases.

• Under Phase I, 10 hospitals received grants and technical assistance to test changes in the emergency room and throughout the hospital to improve patient flow. Each hospital also partnered with a local agency in its community to prepare a report that assessed the capacity of the local health care safety net.
• Under Phase II, the program shifted focus to communicating findings about emergency room best practices. National program staff gathered information about best practices to improve patient flow in hospital emergency departments and served as a clearinghouse for this information. The program's national staff also worked with medical organizations and the federal government to help broadly disseminate best practices.

Key Results

• All Urgent Matters hospitals reduced patient wait times in several areas within the emergency department.
• The 10 hospitals and their community partners produced reports detailing the state of the safety nets in their communities.
• Urgent Matters national program staff compiled a draft toolkit of strategies to achieve best practices for improving patient flow both in an emergency room and throughout a hospital. The toolkit—the first ever, according to national program staff—included a brief description of each strategy, access to other tools and the demographics of the hospital in which the strategy was field-tested. As of April 2008, the toolkit contained 41 best practices with more than 65 associated tools.
  
  Ultimately, this toolkit was not made available to the public. In November 2008, the federal Agency for Healthcare Research and Quality (AHRQ) began a process to test, refine and validate many of the best practices and tools in the toolkit.
• In 2005, the Joint Commission, based in Chicago, which accredits hospitals, added a new requirement for hospital accreditation prompted in part by the work of Urgent Matters, according to National Program Director Bruce Siegel, M.D., M.P.H. The standard requires that hospital leaders develop and implement plans to identify and lessen impediments to efficient patient flow throughout the hospital.

Program Management

RWJF set up a national program office to manage the program at the George Washington University School of Public Health and Health Services, based in Washington. Siegel directed the program.

Funding

The RWJF Board of Trustees authorized the program in July 2002. The Trustees reauthorized the program for the second phase in May 2004. The total authorizations were for up to $6.48 million. RWJF supported the program with grants totaling $5,118,461 between September 2002 and February 2008.