Background

Located just 50 minutes southwest of Atlanta in LaGrange, Ga., WellStar West Georgia Medical Center is a 276-bed facility treating approximately 62,000 patients per year in the emergency department (ED). The newly renovated ED is home to 34-beds, four of which are psychiatric patient beds and eight fast-track beds. Patient acuity levels average in the 3-4 range.

The ED team is staffed daily with four physicians and four advance practice clinicians (APCs) with approximately 41-hours of physician coverage and 44-hours of APC coverage Tuesday through Sunday and 54-hours of APC coverage on Monday. Over a one-year span, the ED implemented new leadership, lowered wait times and improved patient satisfaction.

  • Hospital Beds: 276-beds
  • ED Beds: 34 (dedicated beds for psychiatric patients and fast track)
  • Annual Volume: 62,000
  • Average Acuity Level: 3-4
  • Daily Physician Coverage: 41-hours
  • Daily APC Coverage: 54-hours (Monday); 44-hours (Tuesday – Sunday)

The Challenge

The WGMC ED was experiencing high arrival to provider times and low patient satisfaction scores.

The Approach

The WGMC ED team added a triage nurse in the lobby and an APC to the Rapid Screening Area during peak times, in addition to making several small departmental operations changes to improve efficiency.

Triage Nurse in ED at Peak Times
In the WGMC ED, approximately 165-patients are seen per day, which is more than 5,000 per month and approximately 62,000 annually. Peak times occur between the 12-hour span from 11 a.m. to 11 p.m. During peak hours, the waiting room usually fills up quickly.

Previously, a triage nurse was placed in the lobby one day a week, often resulting in increased wait times and low patient satisfaction scores during peak hours. Now, the triage nurse is in the lobby and an Advance Practice Clinician (APC) is in the Rapid Screening Area seven days a week during all peak times.

WGMC’s ED is a very dynamic environment with admission rates varying from 6% to 19%, with large variations in required resources on a day-to-day basis.

The Result

  • Decreased average door to triage times from 15-minutes to 2-minutes
  • Improved patient satisfaction: Increased Press Ganey overall score 10 percentile points
  • Decreased LWBS more than 50% from 1.23% to 0.55%