Question

HQM - Wk9

1. Using Kotter’s work and other change models from the reading, analyze the performance data for the Emergency Department in the table listed below,

2. Compare the medical care and services to state and/or national standards.

3. Provide recommendations for strategies to improve the Emergency Department substandard performance indicators

Emergency Department HCAPHS Data

	Emergency Dept	State Average	National Average
Average time patients who came to the ED with broken bones had to wait before getting medication	47 minutes	46 minutes	54 minutes
Avg time patients spent in the ED before being admitted as inpatient	246 minutes	218 minutes	200 minutes
Avg time spent in ED after doctor decided to admit as inpatient before leaving ED for their inpatient room	65 minutes	60 minutes	48 minutes
Avg time patients spend in ED before leaving from the visit	140 minutes	116 minutes	116 minutes
Avg time spent in the ED before they were seen by a health care professional	15 minutes	18 minutes	21 minutes

Answer 1

2. Comparisons -

(a) The orthopaedics department of the ED is more efficient than the others with performance better than the national average and marginally below the state level.

(b) Time spent by the patient in ED before being admitted as inpatient ( 248) is much higher than national (200) adn the state average ( 218)

(c) average time spent in the ED after doctor's decision of admitting as an impatient ( 65) is higher than the state (60) and much higher than national level ( 48)

(d) Average time spent in ED by a patient before leaving ( 140) is higher than state and national level ( 116)

(e) Average time spent in ED before they are seenby a healthcare professional is better ( 15) than state ( 18) and national standards ( 21).

Recommendations -

1. First point of contact with the patient works more efficiently than both state and national standards. Other department is Orthopaedics where the ED is better than national and very close to state levle performance. They need to be rewarded and motivated to perform even better.

2. Doctor's examination time ( 65) is much higher than the national and state level. The time needs to be reduced through capacity augmentation ( if needed), training of personnel involved and following best work practices.

3. Those patients who need to be admitted as inpatients wait for almost 3 hours after decision of doctor. The administrative, operational and logistical processes need to improve to ease the trauma caused to the already unwell patient caused by waiting.

4. Those who are not to be admitted as inpatients also wait for more than an hour after the decision of doctor. This is again probably due to operational issues that cause delay in dispensing the medicines or other formalities before patient leaves. These issues need to be identified and corrected.