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Leveraging MEDHOST Reporting to Dramatically Improve ED Operations
Conway Medical Center in Conway, SC, used MEDHOST's reports to optimize staffing and streamline ED processes.
Background: Conway Medical Center, based in Conway, S.C., is a 164 bed hospital in one of the state’s fastest growing regions. Conway’s ED handled nearly 44,000 patient visits in 2007. Realizing the ED’s patient census would continue to grow, administrators began searching for a technology that could streamline ED processes while helping to improve the overall patient experience and the hospital’s financial health.
Challenge: Conway needed to expedite patient throughput and improve workflow which was inherently slow due to manual processes. In addition to operational improvements, Conway sought a solution that would improve documentation and charge capture to prevent lost charges and increase revenue. So, easy and robust documentation as well as a history of clinician acceptance were mandatory requirements.
The hospital recognized that in order to fully restructure how its ED operates, it needed a way to regularly identify trends and process breakdowns. Its EDIS needed a reporting utility so they could easily extract data from patient records and quickly produce reports that administrators could use to track and trend in a variety of ways.
The Solution: A team of representatives from HIM, IT, coders, the medical director and the director of emergency services was formed to search for a solution. The team’s 12 month search included hospital site visits and vendor demos. Ultimately only MEDHOST met Conway’s requirements largely because the system’s ease of use results in higher clinician adoption which yields more accurate and robust data. The quality of data was imperative to ensure decisions were based on solid information.
Conway was live and fully operational with MEDHOST within 90 days of selecting the system and improvements followed soon thereafter. With MEDHOST’s robust Reporting feature Conway was able to quickly measure and illustrate the impact of ED processes with concrete data for administrators to review. Steve Lanning, director of emergency services at Conway, used various MEDHOST reports to improve workflow and patient care and satisfaction.
Lanning leveraged MEDHOST’s standard reports such as daily counts, timelines, physician turnaround time, nurse workload, bed utilization and Core Measures among others. He was able to track and adjust his ED operations based on patient acuity, hourly volumes, staff performance, clinician workload, ancillary department performance, and inpatient admission delays among others. He found added benefit in MEDHOST’s ad hoc reporting capabilities which enabled him to build reports that were unique to his needs but weren’t standard in the system. This gave Lanning flexibility to easily compile information in a variety of other ways including exporting raw data to other applications such as Excel for manual manipulation.
“Being able to pull data in a timely manner has allowed me to improve my staffing pattern according to patient flow by time of day. We staggered staffing and changed shifts based on peak times identified in MEDHOST Reports which helps us better meet the needs of our patients,” Lanning said. “With MEDHOST’s Nurse Workload Report we were able to show the executive team information that justified hiring five additional full-time staff members, two of which were nurses. Physicians also have adjusted their staffing according to patient flow reports, so we now have triple physician coverage during peak times. Having the right people at the right place at the right time has greatly improved our ED’s operations and the satisfaction of our patients. For instance we improved patient throughput by nearly one hour, from an average of 198 minutes to 148 minutes.”
While efficiency was significantly improved, patients were occasionally placed in hall beds during peak times to receive timely care and vital sign monitoring. MEDHOST reports showed that having more patients than available beds wasn’t just a hall bed issue, but that changes to the physical ED environment were needed. Based on Lanning’s findings, hospital leaders accelerated the ED’s renovation and added five ED beds until a longer term expansion was finished.
MEDHOST’s Reporting feature also positively affected Conway’s regulatory compliance. Lanning can now easily meet the South Carolina State Trauma Registry’s monthly report requirements without intensive manual chart review and data collection. MEDHOST enables Lanning to generate and submit the mandatory report easily and on time. Tracking Core Measures for CHF, AMI, and pneumonia patients such as door to EKG and aspirin upon arrival also has helped the ED meet Joint Commission standards and improve patient care. The department also is using MEDHOST to track door to thrombolytics time and ensure compliance.
“Prior to MEDHOST, we were constantly falling short on our Glasgow Trauma Score documentation on patients. After reviewing the information in MEDHOST Reports, I used the system’s ToolKit administrative tool to make this documentation mandatory,” Lanning said. “Since adding this Core Measure documentation requirement our ED has been 100 percent compliant with Glasgow Trauma Scores. It was that simple.”
MEDHOST’s easy to use touch screen and intuitive nature led to a high level of staff acceptance and more real time data collection which is required to generate comprehensive reports. An added benefit of the highly accurate and robust documentation is the impact on charge capture because all elements of care are documented and thus charged. MEDHOST’s automatic Charge Capture feature accrues charges behind the scenes and delivers highly accurate E&M Levels, which helped Conway eliminate lost charges and increase its gross revenue by 23.1 percent. Conway realized a 100 percent ROI within nine months of installing MEDHOST.
Conway achieved additional successes with MEDHOST:
- Improved patient satisfaction scores by more than 10 percent which exceeded administrators’ goals
- The Patient Tracking module improved workflow, communication and access to patient information which led to a decrease in patients who left without being seen (LWBS) from 3.2 percent in 2007 to 1.6 percent in 2008, enabling the ED to increase its annual patient volume by 9 percent
- Patient Tracking served as a “dashboard” that enabled charge nurses to quickly identify bottlenecks and remedy situations in real time
- Patient information is shared from MEDHOST to the inpatient MEDITECH system ensuring that critical details are readily accessible once the patient leaves the ED, vastly improving the continuum of care
“All in all we have revolutionized how our ED operates by deploying MEDHOST. The benefits are impacting patients and the hospital as a whole in ways never before imagined. The system is designed to facilitate better patient care and improve ED processes and it has far exceeded expectations,” Lanning said.