The leadership team at Gadsden Regional Medical Center was frustrated with the performance of the Emergency Department (ED) under the management of its long-time staffing group. Throughput times were long, patients were leaving without treatment, and the ED team was disengaged, resulting in high turnover and locums usage. After conducting an RFP process, the hospital chose American Physician Partners (APP) as its new ED partner due to positive recommendations from other hospitals and its track record for ED turnarounds. The existing providers weren’t committed to making the necessary changes, so APP hired a new medical director and an entirely new emergency physician team. Once the new leader and stable team of local providers were in place, they worked closely with others throughout the hospital on a number of key performance improvement initiatives:

• A focus on bed to provider times and length of stay for admitted patients
• Development of a Rapid Admission Unit to move patients out of the ED quicker
• Implementation of daily morning ED “huddles” to discuss prior day’s performance and address needs for the coming day
• Building a relationship with the University of Alabama EM residency program

Through a focus on these and other initiatives, along with a renewed sense of collaboration with other departments throughout the hospital, the ED was able to achieve the below results, and improvements are continuing.