Facility Components

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How Sacramento’s Busiest ED Doubled Capacity Without Expansion

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Emergency SignThe emergency department (ED) at the Kaiser Permanente South Sacramento Medical Center, one of California’s busiest EDs, has cut patient turnaround times by hours and to far below the national average, through operations improvement, according to Healthcare Informatics. This Level II trauma center saw its workload almost double from 2008 to over 120,000 annual patient visits by 2015. The existing ED space was constrained with only 49 ED bays of which three are dedicated for trauma and four are dedicated to psychiatry. This calculates to 2,500 annual patients per ED bay compared to a recommended 1,500 to 1,800 for a well performing ED. The increasing patient volume and space constraints resulted in long ED wait times with patients waiting five to six hours to see a doctor and every night there were 30 to 40 patients in the waiting room.

After an intensive operations improvement effort using “lean” production principles, South Sacramento Medical Center’s average wait time in the ED was reduced to 19 minutes, less than half the national average of 58 minutes. The average length of stay (LOS) in the ED was reduced to 43 minutes for low-acuity patients compared to a national average of 118 minutes. The LOS for discharged patients was decreased from 4.5 hours to about 2 hours and the LOS for admitted patients dropped from 8 to 6 hours. According to Karen Murrell, M.D., the chair of emergency medicine at Kaiser Permanente Northern California, “Decreasing the length of stay creates capacity, so if we have a patient in a bed for two hours rather than four hours, we can see twice as many patients.”

Source: “How Eliminating Waste and Opening Data Helped Kaiser South Sacramento Create a “No Wait” ER” by Heather Landi, October 23, 2015 [Retrieved online at www.healthcare-informatics.com]

This article is an update of a previous post.

Mercy Opens World’s First Virtual Care Center

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Mercy, a not-for-profit Catholic health care organization located in the Midwest, opened a four-story, 125,000 square-foot Virtual Care Center in Chesterfield, Missouri. The facility not only houses the nation’s largest single-hub electronic intensive care unit, but also provides a center for telemedicine innovation and a testing ground for new health care products and services. Using highly sensitive two-way cameras, online-enabled instruments and real-time vital signs, clinicians “see” patients that may be in one of Mercy’s traditional hospitals, a physician office, or in some cases, the patient’s home — 24/7, 365 days per year.

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Clinical Operations Center Provides Second Set of Eyes

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CHI Franciscan Health System’s eight hospitals are scattered across Western Washington but they are all tethered to a virtual hub located in a former bank building in Tacoma. In this clinical operations center, teams of technicians, nurses, and caregivers use technology to provide an extra set of eyes across its regional health system, from miles away, for busy physicians and nurses on the ground.

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Key Ways Hospital Design May Affect C-Section Rates

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According to a new report published by Ariadne Labs and MASS Design Group, the physical design of a hospital’s birthing unit may affect its Cesarean section rate. Based on previous research, the team knew C-section rates can vary from 7 percent to 70 percent simply depending on the facility. As many as half of these C-sections are unnecessary and add surgical complications and increase costs. To begin to determine how much the physical layout of a hospital may impact C-section rates, the team chose 12 diverse childbirth locations — three birth centers and nine hospitals. They conducted site visits and phone interviews to develop facility profiles and compare the childbirth locations as quantitatively as possible.

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Shared Medical Appointments Are Becoming a New Outpatient Care Option

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Most patients wait alone in a cramped exam room for a scheduled appointment as their physician rushes through back-to-back individual patient visits lasting an average of 22 minutes each. With the growing trend of shared medical appointments, a patient and his/her peers spend a full 90 minutes with their personal physician. Shared medical appointments are a small but growing part of primary care as well as for a variety of medical specialties. According to the American Academy of Family Physicians, the percentage of its members offering shared medical appointment more than doubled, to nearly 12 percent, between 2005 and 2012. At the Cleveland Clinic, nearly 10,000 group appointments were logged between 2002 and 2014. Promoted as the wave of the future in outpatient care, group appointments are changing the way physicians and patients view medical treatment.

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Robotic Nurse Being Developed To Assist Infectious Patients

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Robot NurseTrina — which stands for Tele-Robotic Intelligent Nursing Assistant — is a first-generation nursing robot that is being built by a collaboration of Duke University’s engineering and nursing students and staff. Since the Ebola outbreak in 2014, new technologies, including robots, are being tested as alternatives to human contact to diminish risks for providers as they care for patients with infectious diseases. Funded by a National Science Foundation grant, Duke officials started working on the $85,000 robot about a year-and-a-half ago.

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