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Dear Friends and Colleagues,

It is no revelation that the emergency room system in our country is ailing. Headlines report long wait times and massive overcrowding leading to unnecessary and shocking deaths in our emergency waiting rooms.

Though wait times are a big contributor, the problem runs deeper - to the very core of patient care operations.

We see a decline in the performance and number of emergency facilities. We see a rise in the number of patients that use them. We see an urgent need for fundamental reform and reinvention of patient throughput processes.

EMPATH has a well-documented history of fixing emergency departments. Our client's high patient satisfaction scores are testament to this. What's more important is that we continue to develop solutions that bring real results. With top notch action plans, proactive staff management, real-time monitoring and systems of accountability, putting patients at risk with extended wait times doesn't have to be the reality.

Please read further to learn more.


Best regards,

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Michael B. Hill, MD, FACEP
President & CEO
EMPATH Consulting
michael.hill@empath.md
888.436.7284 ext. 5902
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Worth Repeating
"The results that we achieved through EMPATH's work far exceeded everyone's expectations of what was actually possible in patient care delivery throughout the hospital."
— Kathleen H.
Chief Nurse Executive


EMPATH Client Receives Highest Quality Incentive Payment

During the first three years of this CMS pay-for-performance project, participating hospitals have raised quality of care in five clinical areas by an average of nearly 16%. This year, Sacred Heart Medical Center in Spokane, Washington has been named the top performer.

Out of 112 top performing hospitals, Sacred Heart was awarded the highest quality incentive payment for their top marks in four out of the five targeted areas.

This project is designed to determine if economic incentives to hospitals are effective at improving the quality of patient care. At participating hospitals, quality data is collected on heart attacks and heart failure, coronary artery bypass graphs, pneumonia and hip and knee replacements on a voluntary basis. Measurement is made through 30 evidence-based clinical quality indicators that were developed by government and private organizations.

Sacred Heart ranked in the top 10 percent in the country for overall quality in the clinical areas of heart attack, congestive heart failure and total joint replacement, and in the top 20 percent for coronary artery bypass grafting surgery.

"There is definitely a connection between quality and operations performance. Better patient care operations means patients are seen faster and more effectively. They are also sent home sooner and statistics show that those patients who spend less time in the hospital have better outcomes. Operationally, it used to be that a busy day in our ED was 130 patients; now it's 230. House-wide, we used to be literally packed with 380 inpatients, and now we are routinely handling over 500. There has been a significant difference in our ability to provide quality and to manage operations with EMPATH's work hospital-wide," explains Elaine Couture, COO of Sacred Heart.

Congratulations to our client — a top-performing hospital — as they continue to set the bar for highest quality patient care nationwide.


Why Won't This (ED) Problem Just Go Away?
Questions that can help fix your ED

1. What are your designed processes?
   — How consistently are they performed on days, nights and weekends?

TIP:
Tactical initiatives cannot address the complexity of ED processes. Design your solutions for end-to-end accountability between staff and between departments.


2. For improvement that sticks, measure performance by week, by shift, by unit and by role (including charge nurse and physician). Do you know how your ED performed last week?    — Are your metrics granular enough to create systems of accountability?

TIP:
For improvement that sticks, measure performance by week, by shift, by unit and by role (including charge nurse and physician).


3. Do you have a formalized support system that tells your CN what back up systems to activate on a 1/2 hour basis? Do you know:
   — Which patients are awaiting triage, an ED bed, an MD visit or an inpatient bed?
   — Your staffing resources?
   — Performance on LOS, holds, MD care, transport and housekeeping?

TIP:
Only real-time monitoring of Key Performance Indicators can give you the right information you need.


4. Do the ED, lab, radiology, bed control, and all inpatient unit managers use a consistent process to review data, perform assessments of the gaps, and develop action plans?
   — Do they know the greatest opportunities for improvement?

TIP:

Give your managers meaningful metrics, monitoring tools and action plans.



This graph represents our client hospital's experience as a result of consistently managing ED operations through metrics, real-time monitoring tools and action plans. In less than four years they doubled the number of ED patients treated per bed.


Southeastern U.S. Hospital Continues Its Performance Gains

Beginning in early 2007, one of our clients fundamentally changed its patient care operations. By designing new processes, measuring those processes in detail, and monitoring weekly, daily and hourly performance, they have made rapid improvements in how they care for and move patients through the hospital.

"We see over 400 patients a day in our emergency department, with 120-130 in the department at any one time. We used to have long waits in the lobby and lots of patient boarding. Now, seeing the same number of patients, we have minimal waits, fewer patients leaving before treatment, and much greater patient satisfaction."
Amy — Charge Nurse


"The tipping point came when we saw the dashboards showing that we were actually improving. Staff now sees that they have made these accomplishments. Giving them feedback that is data-driven is what we need to keep getting better. Improvement is no longer a feeling but a concrete result."
Maria — Project Leader & Six Sigma Black Belt
Results







EMPATH Inc. 1160 Brickyard Cove Road, Ste. 110 Point Richmond, CA 94801 (510) 215-6220
web: www.empath.md email: info@empath.md
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