Edward Hospital & Health Services - Naperville, IL

Success Story Finalist

An increased demand for services coupled with the nursing shortage and high patient expectations lead to frustration amongst caregivers. We implemented initiatives that were recommended by benchmark facilities. Additionally, we opened a Pediatric Emergency Department adjacent to the main ED and initiated scripting for common situations. But there was more progress to be made.

The leadership team discussed a strategy of dividing our big, busy ED into a smaller team approach.

The ED was divided into two smaller teams each consisting of 10 beds, 1 ED physician, 3 RNs, 1 tech and a unit clerk. The goals of the process improvement initiative were to improve efficiency and patient satisfaction.

At monthly team meetings, our patient satisfaction reports are reviewed to determine how patients are receiving the new model.

The department required some inexpensive redesign to allow for two nursing stations and enough computers and workspace for the staff on each team. The ED Nurse Manager and Director were visible on the unit 12-16 hours/day during the first couple of months to manage the change process.

There was considerable resistance from nursing and physicians in the beginning, but in the end, the groups identified there were more advantages than disadvantages. Several minor modifications were made to the initial plan. We still meet monthly to discuss issues.

Results
The ED is most proud of the improvement we have seen in patient satisfaction results. In 2000, we were at the 34th percentile. In 2003, we moved to the 98th percentile.

An unexpected result of the model of care change, was an increase in employee satisfaction and a dramatic decrease in annual employee turnover in the ED from 39.1% in 2001 to 8.4% in 2003.

Feedback from attending physicians and case managers who come to the ED has been extremely positive since the implementation of the model of care. We have exceeded the goals that were initially established!