Facility: Waterbury Hospital in Waterbury, CT
Patient Volumes: 55,000 Annual ED Visits
TeamHealth Service: Emergency Medicine Staffing
Like many hospitals in New England, Waterbury Hospital had long used outside agencies to staff and manage the physicians practicing in its emergency department (ED). In 2015, the hospital's executive team determined that the contracting group they were using for the ED was not performing well. Two areas where the group's performance fell short were recruiting and retaining high quality ED providers, and engaging with the entire medical staff of the hospital to enhance throughput and improve ED quality metrics.
Waterbury Hospital chose TeamHealth as its ED staffing partner. Mark Holtz, chief operating officer of Greater Waterbury Health Network, parent company of Waterbury Hospital, had seen the results TeamHealth achieved at a previous ED and felt confident that a similar win-win situation could be realized at Waterbury Hospital.
"The hospital chose TeamHealth because we felt they had the resources, track record and wherewithal to help achieve what we wanted to achieve in the ED," says Holtz. "The one component in this engagement that was missing is the spirit of partnership with TeamHealth. The Emergency Department can't function as an island. It has to operate within the larger context of the broader hospital to deliver high quality, efficient and highly satisfying care to our patients. TeamHealth's experience and resources have enabled us to change the culture in the ED and we're hoping that change spreads across the organization."
A key concept in the change culture is the universal understanding of all stakeholders that the ED is the hospital's front door. "This philosophy of interconnectedness, what someone in the ED does has an impact both across and up and down the organization and what we do as a leader affects the ED, will help us achieve and sustain the culture change we desire," he says.
One of the biggest challenges Waterbury Hospital's ED faced was the growing percentage of patients leaving without being seen that stemmed from long waits and numerous barriers to moving patients through the system and out of the ED to a bed or home. This key metric has seen tremendous improvement, falling from around 4.5% to less than 1%. Overall length of stay has declined 71 minutes from 270 down to 199 minutes, well ahead of the ED's goal of 250 minutes. Another key ED metric, door-to-provider time, has been reduced to 13 minutes from 57 minutes. Holtz says the ED Performance Improvement Team examined every process that impacted throughput.
"The biggest takeaway from our partnership with TeamHealth is that you can plant seeds, but you have to have fertile ground," says Holtz. "Senior leadership has the willingness to make the kind of change that will lead to the positive improvement that will make everyone's job easier and improve the patient experience. We are all in the boat with TeamHealth, going in the same direction."
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