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Improving Emergency Department Effectiveness at Martin Luther King, Jr. Community Hospital

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By removing roadblocks to effective communication, strengthening departmental alignment and improving leadership collaboration, Martin Luther King, Jr. Community Hospital (MLKCH) was able to create a seamless patient experience within its emergency department (ED).

Challenge

MLKCH sought to improve its ED operations and patient experience. Inefficiencies in patient flow had increased wait times, resulting in a high length of stay for discharged and admitted patients, exacerbating existing capacity issues. Patients arriving to a busy waiting room often didn’t understand what to do if they had questions while awaiting care. These factors combined contributed to an overall poor patient experience, which inhibited growth in patient volume.

Approach

Together, Huron team members and MLKCH leaders assessed the ED experience as a whole, focusing on making flow and throughput more efficient. Then, the teams narrowed their focus to improving specific elements of the patient experience, such as wait times, patient and family communication upon arrival, and admit decision time. By simultaneously tackling patient flow and initial communication with patients, the teams were able to isolate individual problem areas and develop strategies to create a new, cohesive ED experience. The teams were able to accomplish this by:

Results

Increased ED volume by 7%

Reduced admitted patient length of stay by 27%

Decreased LWBS rate by 17%

Overall rating of ED increased from 58.7% top box to 68.6%

Enhancing communication. Utilizing a standardized framework for communication, Huron and MLKCH were able to optimize the sharing of critical information between leadership, physicians, medical staff and patients. This created greater transparency across the department and ensured strategic alignment of leaders and staff, both of which dramatically reduced wait times and admitted patient length of stay.

Empowering leaders with visibility. Huron and MLKCH implemented a robust leadership evaluation system that establishes and tracks ED-specific goals, such as improving outcomes and reducing costs. The system aligns those goals to key performance indicators (KPIs), making it easier for leaders to determine if their teams are on track to meet their goals or if they need to change course. The ongoing visibility of goals and their corresponding KPIs enabled leaders to make faster decisions about where to focus to improve patient experience metrics, such as the length of stay.

Huron dramatically improved our communication with patients and within our ED leadership group. They equipped us with an approach that improves the patient experience without sacrificing efficiency and throughput.” — Oscar Casillas, M.D.

Supporting physicians and staff to deliver better patient experiences. Making departmental meetings shorter and more productive increased staff engagement during meetings and improved retention of information afterwards. It also gave leaders more time with their teams in the field where they could validate new behaviors they learned in intensive training sessions, such as more frequent patient rounding, adhering to a new process for determining the pre-triage queue and resetting expectations for turnaround times of diagnostic testing. The added clarity made physicians and staff feel more confident and supported in their roles, which in turn helped them deliver better care experiences to patients.

Martin Luther King, Jr. Community Hospital is a private, nonprofit, safety-net hospital serving 1.3 million residents in South Los Angeles. The hospital is committed to establishing an innovative model focused on patient-centered, coordinated care delivery, both inside and beyond the hospital walls.

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