Making the ED More Efficient

The ED where I work has but 12 beds. They use a combination of scheduling, specific assignments, and use of a Fast Track system to keep flow though the department reasonably efficient. They see around 70 patients per day, with the vast majority being seen between about 10 am and midnight. Of those 12 beds, 3-4 are usually FT beds and that area takes all the level 4 and 5 patients. The ED also employs a PA that sees those patients, and consults with the MD, as needed, and sometimes that results in the MD seeing a patient or two in FT. As far as the scheduling goes, they bring in a nurse right before the load really gets heavy, lunches get done, then FT opens, and after a little while, another RN is brought in, and everyone drops their patient load from 1:4 to 1:3. All beds, of course, can handle all acuity level patients. Toward the end of the day, or as the numbers of level 2-3 patients drop off, more level 4-5 patients are brought to the "main" portion of the ED and that also improves throughput.