title: Improving door-to-physician times in 2 community hospital emergency departments.
abstract: Door-to-physician time in the emergency department (ED) correlates with patient satisfaction and clinical quality and outcomes. Delays in seeing a provider result in a 3% nationwide rate of patients leaving without being seen (LWBS) after presenting for ED care. Two community hospitals had door-to-physician times of 51 and 47 minutes. The LWBS rates were 3% and 2%. A quality improvement project was initiated with a change package, including prompts, training, and feedback. Door-to-physician times decreased to 31 and 27 minutes. The change occurred in less than a month and was sustained for 6 months after the study. In addition, the LWBS rates at each facility fell by one third. Basic process improvement strategies borrowed from service industries were used in 2 EDs to improve the door-to-physician process.
authors.affiliation: Intermountain Institute for Healthcare Delivery Research, 36 South State Street, 16th Floor, Salt Lake City, UT 84111-1633, USA. sjwelch56@aol.com
authors.forename: Shari
authors.initials: S
authors.lastname: Welch
authors.forename: Joseph
authors.initials: J
authors.lastname: Dalto
mesh_terms: D001071:Appointments and Schedules; D003463:Cues; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006764:Hospitals, Community; D006801:Humans; D007318:Inservice Training; D008331:Management Information Systems; D011446:Prospective Studies; D058996:Quality Improvement; D017010:Reminder Systems; D017751:Safety Management; D013997:Time Factors; D014218:Triage; D014589:Utah; D057188:Workflow