Emergency department (ED) overcrowding and related patient flow problems continue to trouble health care leaders.

But both Utah Valley Regional Medical Center, Provo, Utah, and the University of Virginia Medical Center (UVMC), Charlottesville, Va., discovered that ED patient flow rates can improve. Sometimes it just takes some outside help.

Both recently partnered with Huron Consulting Group, Chicago, to implement its Clinical Operations: ED Flow solution and experienced marked improvements in key processes over a nine-month period.

Becca LaFond, senior director, Huron Healthcare, says keys to improved patient flow include:

  • determining correct ED staffing levels to meet patient demand;
  • identifying a staff member with centralized accountability and oversight for patient flow;
  • conducting frequent patient flow rounds involving all care team members.

Prior to working with Huron, the ED at UVMC had made positive changes in its patient flow but failed to make them permanent, says LaFond.

In the final month of partnering with Huron the length of stay in the ED was reduced by 34 minutes, which will allow the department to see an additional 4,000 patients per year, LaFond adds. The new system reduced the average time from when patients enter the ED to being placed in an ED bed by six minutes or 16 percent, and cut the time from doctor disposition to patient discharge by 12 minutes or 28 percent.

Utah Valley's ED already was performing good compared with national benchmarks when it partnered with Huron, but it ranked lowest among 23 hospitals in the Intermountain Healthcare system, based in Salt Lake City. A 28-minute reduction in the average time patients waited to see a doctor, a 7 percent reduction in length of stay from 180 to 168 minutes and a reduction from 1.7 to 0.5 percent in the rate of patients who leave without treatment were achieved.

"We have greatly improved the community perception of our ED as we have made these gains," says John Resch, ED nurse manager, Utah Valley Regional Medical Center.