How Sacramento’s Busiest ED Doubled Capacity Without Expansion

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]

This article is an update of a previous post.