Emergency Room Wait Times: Evaluation Tool Summary and Critique
An evaluation tool for measuring the effectiveness of the implementation of the business plan for reducing ER wait times can be implemented to monitor the success of the plan. The three approaches combined into the plan that are expected to reduce wait times include the incorporation of lean production techniques, reconfiguration of ED space, and the use of the Rapid Medical Evaluation Program for getting patients seen more quickly. The evaluation tool will assess ER wait times with a view toward measuring the impact of each of these changes.
Lean production techniques such as value-stream mapping and just-in-time delivery will not only reduce ER wait times, they will also improve the flow of patients through the ER, reducing bottlenecks. To measure the extent of this impact, the evaluation tool will use the ER computer system to tabulate times. When an ER patient arrives, this will register in the system as "arrival time." The time that the patient processes in is "process-in time." The patient's status until processing out will be input into the system whenever it changes. The first status may be "waiting for a bed" or "waiting for tests," while the next status may be "waiting to be seen by doctor." All subsequent times at which the patient is treated by a nurse or a doctor will be captured by the system as the patient's RFID ID tag will be scanned each time and the service performed will be recorded. Process-out time will be recorded as "process-out time." Thus, the full trajectory of a patient's stay in the ER will be recorded in the system, with all times and dates noted. The system can use this data to produce reports showing bottlenecks and the relative speed with which patients move through the ER per hour. Reconfiguration of ER space is expected to reduce the number of patients and length of time that "waiting for a bed" is the st...