Partnership
- Facility: Sharp Grossmont Hospital, a 500+ bed hospital, part of Sharp HealthCare in Southern California
- Services: Emergency Medicine
Addressing Issues Confronting the High-Volume Emergency Department
Sharp Grossmont Hospital (SGH) in La Mesa, California, part of Sharp HealthCare, has an emergency department (ED) patient volume of more than 112,000 visits each year. The facility faces many throughput and efficiency issues that are common to high-volume EDs, including capacity challenges, wait times, staffing and workforce issues, flexibility in treating a variety of acuity levels and ensuring a positive patient experience.
Working with long-time service line strategic partner TeamHealth, the hospital has been able to successfully navigate these and other challenges to achieve unprecedented metrics and operational performance in a setting with increased patient volumes each year.
Solutions Tailored to Partners’ Unique Challenges
Last June, leadership engaged TeamHealth, the hospital’s long-term emergency medicine partner, in a collaborative, intentional process to proactively address challenges that were impacting department performance. Together, hospital leaders joined with TeamHealth’s on-site medical and operational leaders as well as members of TeamHealth’s Performance Improvement Consultants (PIC) team in a two-day planning session.
The cornerstone of the session was a focused emphasis on optimizing critical performance metrics and creating an innovative approach to maximizing existing space across the department to improve patient flow. Applying the lessons learned in working with large, high-volume EDs in communities across the country, TeamHealth’s PIC team oversaw the development of a dedicated performance improvement plan, the key components of which included:
- Developing internal champions to lead culture change
- Implementing team-in-triage to better empower clinical staff to address lower acuity patients
- Assigning physicians to the ambulance bay utilizing a staggered shift formula
- Utilizing Cognition, TeamHealth’s proprietary staffing optimization tool
- Improving utilization of existing space to add an APC station
- Committing to a regular cadence of bi-weekly calls
Results that Meaningfully Impact Quality Care and Performance
The results of this shared commitment to collaborative, data-driven success continue to remain impressive. Since the initial rollout of recommendations developed during the June 2023 brainstorming summit, the hospital has seen:
- Discharge length-of-stay reduced by 30 minutes
- Door-to-provider times reduced to less than 20 minutes
- Left without being seen (LWOT) reduced by 90%
- Patient experience improved to the 76th percentile
Beyond these impressive statistics, the hospital staff notes the following insights as contributing to the high level of ED performance:
- Increasing door-to-provider times and reducing length-of-stay for discharged patients integral to increasing patient experience scores.
- Utilizing TeamHealth’s proprietary Cognition tool to better align staffing with arrival volumes (including inside the ambulance bays) contributed significantly to decreasing door-to-provider times.
Performance Improvement in a High-Volume Emergency Medicine Setting
Navigating the post-pandemic environment has forced every hospital to re-examine processes associated with ensuring high-performing emergency care. Complicating these challenges is a patient volume that rates this facility as one of the busiest EDs in the nation. What these impressive results underscore is the value of a strategic partner who understands the issues impacting ED efficiency and likewise has the experience to guide a shared, collaborative approach to rapid process improvement.
TeamHealth was founded on a commitment to improve clinical quality and patient safety, and our robust menu of quality and throughput initiatives reflects this dedication. Across our 45-year history, we have grown from a single service line focus of emergency medicine to an integrated model that encompasses the entire care continuum. Beyond our boots-on-the-ground leadership, we count on our PIC team and our innovative technology to help our partners address the clinical quality, patient safety and operational challenges they face each day. To connect with our team and learn more, please reach out to us.