Drowning in the ED? NEDOCS Program at St. Rita’s Acts as Lifeline for Patient Satisfaction

By Jodi Pahl, Chief Nursing Officer, St. Rita’s Medical Center  /  15 Jul 2013

A leader in providing comprehensive healthcare services for residents in West Central Ohio, St. Rita’s Medical Center is comprised of nearly 4,000 employees, physicians and volunteers who work to meet the healthcare needs of its community.

The emergency department is the “front door” of every hospital or health system, and ensuring that patients move from the ED through the rest of the care continuum in a timely fashion is critical. Such a feat can be challenging, especially when there is little visibility into ED patient levels and hospital capacity on a real-time basis. With an admittance rate that’s higher than the national average, St. Rita’s needed to create this visibility in order to better manage patient flow during high-volume periods in the ED and keep patient wait times to reasonable levels.

To that end, we kicked off the National Emergency Department Overcrowding Score (NEDOCS) program in January of this year. A national standard for calculating hospital capacity and crowding, NEDOCS’ are calculated by comparing the number of beds available in a facility to the number of patients in high acuity care areas to the number of patients waiting on a hospital bed or services. We began calculating our scores every two hours, and implemented a communications platform that alerts all clinicians in the hospital when we cross into the “red zone,” asking them to help out if they’re available to do so.

With this program in place, we know that when the NEDOC score is high, patients are experiencing much longer wait times, and this can become extremely frustrating for them. A two-hour wait in the ED is unacceptable. Before implementing this system, we didn’t have a way to let in-house clinicians know that we were drowning in the ED. Today, we’ve broken down the communication silos that previously existed between our ED and the rest of the hospital – and we’ve successfully reduced both wait times and walk-out rates.

An example of how this works: One Friday evening, we hit that “red level” and a message was sent out. Available physicians and nurses were able to help ED staff by working with patients they knew were going to be admitted and funneling them to the right care areas within the hospital, which meant the ED folks could focus on the patients that truly needed emergency attention. We were able to quickly decrease wait times for patients in the ED and return to normal NEDOCS levels in no time.

Timely communication around the NEDOC score is critical to making this program a success. Secure text messaging is usually the preferred method, because it easily grabs clinicians’ attention, as compared to emails that may be a few clicks away or calling each person individually – especially when what we’re trying to do is save time. Making sure each clinician receives the information in a quick, secure and accurate form is the only way we’ve been able to leverage NEDOCS to our advantage.

Now, ensuring ED efficiency has become a facility-wide concern, and we’re able to respond to ED patient overflow more rapidly than ever before – which has direct impact on patient care and patient satisfaction.

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