The Pipes are Clogged: ED Boarding & Hospital Capacity

The number one call I received over the last year was "What can we do to relieve the ED boarding and create hospital capacity?".

This must be one of the top healthcare issues keeping healthcare executives up at night, and yet there are proven solutions. Key stakeholders are often not willing to make hard decisions or to take swift and decisive action to remedy the problem. The problem is complex yes, but not impossible to overcome. Our Emergency Centers are in a crisis state and we must leverage every tool in the toolbox to clear the bottlenecks. Are you leveraging the following tools?

 ED Capacity:

• Create a mindset and methodology for treating only emergency department patients in your ED.
• Sort your ED into a vertical flow model for patient flow
• Commit to a Medical Screening Exam Process for non-emergency visits.
• No one owns a bed unless they are being admitted.
• Create a result waiting room & a discharge lounge
• Commit and execute the pull to full & push methodology.
• Advertise & implement telehealth solutions in and outside of the ED
• Actively partner formally & informally with behavioral health, skilled, medical respite & community agencies
• Establish an ED capacity & hospital capacity algorithm for patient flow with escalation & response levels.
• Case manage & navigate patients to the right treatment setting.
• Meet with primary care providers to create capacity plans that include electronic, telehealth & phone visits.
• Establish nurse treatment centers for non-urgent visits
• Leverage an air traffic control center in the ED & hospital, or transfer center with clear accountability in patient flow  

Educate the community regarding the right place for the right care.

As you evaluate the levers to pull, consider the risk of patients sitting for hours in your emergency center, lying in hallways, and leaving without being seen.

Stay tuned for Hospital Capacity Bottlenecks & How to Clear the Clog.