News & Resources

Like It? Share It

Metrics: NCH Healthcare System, Naples, FL

Case Studies


The North Campus and Downtown Campus emergency departments (EDs) at NCH Healthcare System (NCH) were experiencing lower than desired patients satisfaction scores as well as high turn-around times, door-to-doctor times, and left without being seen (LWBS) rates.


The hospital selected TeamHealth because of its reputation for helping hospitals improve patient satisfaction levels and quality of care.

To kick-start our efforts, the ED team at NHC and TeamHealth fostered a feeling of shared ownership for the improvement program by jointly presenting the hospital’supper management with an operational assessment and comprehensive process redesign. The primary goal was to create a new patient-centered flow for the ED.

Nine countermeasures (detailed below) were implemented to meet the end-target goal of increasing patient satisfaction scores to the 90th percentile. In addition, a board displaying the performance scores was posted in each ED so the target objects were kept top-of-mind.

  • Create an ED Action Team
  • Enhance charge nurse role
  • Shorten the triage process
  • Implement direct bedding 24/7
  • Realign provider staffing
  • Conduct ESI level training
  • Realign RN staffing
  • Establish discharge/disposition room
  • Establish rapid treatment protocols for ESI levels 4 and 5


The countermeasures realigned the ED’s focus and achieved strong results, as noted at left. Most importantly, patient satisfaction significantly improved from the 17th percentile to the 99th percentile.


For the full case study, click Download below.