With a steadily increasing patient volume and relatively small emergency department (ED), Blount Memorial Hospital sought a solution to move patients through its ED faster. The hospital formed a performance improvement team, led by Dr. Dan Hunter, American Physician Partners medical director for Blount’s ED, and Dr. Deaver Shattock, the medical director for the hospital medicine program. This team was tasked with identifying solutions for ED holds and admission delays that were backing up the ED, patients arriving earlier than provider and nursing coverage was scheduled, and spikes in patient volumes. A number of initiatives were implemented including:

• Holding teams accountable for daily metrics
• Revamping triage with a pull-to-full process
• Adjusting schedules to meet arrival patterns
• Implementing a rapid admission process

These initiatives had a rapid and meaningful impact on key ED metrics, as indicated below.