Faraaz Bhatti, MD, FRCEM, LLM, MBA, Facility Medical Director, Emergency Medicine, Los Robles Regional Medical Center
Partnership:
- Facility: Los Robles Regional Medical Center, a 382-bed acute care hospital in Thousand Oaks, California, part of HCA Healthcare
- TeamHealth Services: Emergency Medicine
In June of 2024, TeamHealth and Los Robles Regional Medical Center embarked on a partnership to bring exceptional healthcare to the Thousand Oaks, California, community. The Los Robles emergency department was under construction, and the team only had 30 days to complete the transition, which normally is accomplished in 90 to 120 days. Previously, the emergency department had suffered from poor community perception, and the department was not performing to its fullest potential. The Los Robles leadership sought to drive change and better serve their community, so they partnered with TeamHealth.
Creating Change
What was immediately evident to the team was the need to navigate a department physically in flux through construction while guiding vital change management. “One of the biggest opportunities we had was a culture change in the emergency department,” says Scott Scherr, MD, FACEP, Regional Medical Director. “Everybody was working in silos, but we tore down that wall to where everybody’s voice matters and everybody is held accountable to providing excellent patient care.” To accomplish this, they focused on process and culture improvements.
Implementing New Processes
One of the emergency department’s previous challenges was the wait time. Patients were leaving without being seen, their time from door to provider was low, and overall, the department was facing throughput issues that rippled to other departments. In response to this challenge, TeamHealth immediately began a front-end process strategy to get patients to providers quickly. “None of these improvements happened in isolation,” says Faraaz Bhatti, MD, FRCEM, LLM, MBA, Facility Medical Director. “There was an intentional process design.” The new patient flow process allowed patients to be seen faster, decreasing wait times, strengthening care, and improving patient experience. To better align staffing with real-time demand in the emergency department, TeamHealth brought our advanced analytics platform, Cognition, to Los Robles.
In addition, the team also revamped the patient experience process. TeamHealth’s proprietary patient experience program, APEX, provides turnkey and tailored strategies to enhance patient experience. The toolkit boasts a wide range of tactics, including shadow rounding guidance, proven communication standards, and on-site and ongoing training for staff. The emergency department held an APEX Live event in April 2025, bringing TeamHealth’s Performance Improvement Consultants to the hospital for education and training. The event was the largest in TeamHealth’s history to date, with 266 providers from multiple departments attending.
Managing Culture Change
Along with process changes, the team saw a valuable opportunity to strengthen the emergency department culture. Before, the emergency department tended to work in a silo, so communication and collaboration across departments was a distinct challenge. However, the new facility medical director, Dr. Bhatti, along with TeamHealth’s regional leadership, sought to better integrate the emergency department within an interdisciplinary team across other vital departments, such as radiology, lab, inpatient care, and more. With vast experience implementing integrated structures, TeamHealth’s leadership worked closely with the C-suite to break down silos and create cooperation across services through better relationships. “The support we’ve gotten from the executive leadership at the hospital has been instrumental,” says Scherr.
“We put the right leaders in place to make the changes that we do… so that it could be sustained, and they can get these wins” – Nikki Monroe, MSN, MHA, RN, Senior Vice President of Operations
Finally, the team also engaged in wellness and recognition events to prioritize clinician well-being and retention. These programs bring well-deserved recognition to the clinicians who work tirelessly to provide excellent care. “To do this and be successful at it takes a great team,” says Scherr. A notable example was the emergency department’s “Eat Your Cake!” patient experience recognition to celebrate exceptional patient experience wins.
Strengthening Metrics
The efforts from Los Robles and TeamHealth have proven that strong partnerships can have far-reaching impacts. The community’s perception of the hospital has drastically changed for the better, and best of all, they are receiving the quality of care they need, when they need it. “I felt I’ve had incredible support from TeamHealth leadership… without that support, these metrics would not be an easy gain,” says Bhatti. “It’s really been a team effort all around.”
The team’s impressive results are even more startling given the department’s role as a graduate residency program. While this can have negative impacts on metrics as new residents are being trained, the team has changed and maintained their outstanding results, all while continuing to train new residents. Specific results include:
- From May 2024 to April 2025, the walk-out rate improved from 5.50% to 1.80%
- From May 2024 to April 2025, arrival-to-greet time improved from 33 to 7 and arrival-to-order improved from 26 to 9
- From May 2024 or April 2025, low-acuity discharge length of stay improved from 122 to 50, and level three discharge length of stay continues to improve
- Top box scores continue to improve from a low of 55.32% in Q2 2024 to 65.23% in Q2 2025
Conclusion
The success at Los Robles Regional Medical Center’s emergency department highlights that the right partnership can drive change for the better. TeamHealth brings reliable resources and leadership to each of our partnerships. The support we provide and the quality care we deliver transformed the Los Robles emergency department and now allow them to provide exceptional care to their community. If you’re interested in exploring how TeamHealth can similarly support your organization, we invite you to connect with our team.