crowded ER, solution?

[phiposurde]

We are living an amazing increase of acuity at my center. The population as almost double but not the hospital. The issue of flow as become to topic of the day. I was wondering how some of your departments have manage such events?

[MOOSEMAN]

My last ED we added 2 MD's and a Mid level. We change using LEAN. We open 2 perform care rooms, an obs area. We increased RN's by 2 and PCT by 3. We went from an average lobby wait time >6 hrs down to 2 hrs. Our left without seeing Doc dropped to less than 2 percent. Our overall pt satisfaction increased. I went from running 8 hallway beds to only the occ EMS offload. Our visits increased from 24,000 in 2002 to 51,000 last year. This is only a 21 bed ED.

[teeituptom, BSN, RN]

Our total overall average wait time from door to dispo is a bit under 2 1/2 hours. Fast Dispo always helps.

[JessicRN]

We are also not allowed to divert so patients back up everywhere. Our average dispo is 4-6 hrs worse if they have to be admitted. The admitting team usually cames done an orders tons of tests that could be done on the floor but " it is easier if they do them in the ED. We would love a solution as well