Improving Care in Emergency Departments

Three Southeast Michigan hospitals, DMC Sinai-Grace Hospital, St. Joseph Mercy Oakland, and McLaren Macomb, improved care in their emergency departments (EDs) through a national program made possible by AF4Q Detroit, led by the Greater Detroit Area Health Council. The collaborative effort from 2010 to 2012 resulted in patients spending 9,764 fewer hours in the ED, and an estimated 268 more patients received care who otherwise would have left before being seen by a provider.  

 

During the 18-month AF4Q Hospital Quality Network program, 90 percent of participating hospitals improved quality by reducing hospital readmissions, improving patient safety, improving customer satisfaction, and reducing problems in emergency departments. To achieve this improvement, hospitals collaborated with community members and used a variety of interventions. McLaren Macomb reduced readmissions by instituting a patient education program that instructed heart failure patients how to care for themselves better upon their return home. The Alliance’s multi-stakeholder Emergency Department Utilization Team developed strategies to reduce emergency department use for primary care physician-treatable conditions. The group developed a toolkit that included a welcome letter, poster, telephone script, access to care policy, and post-ED visit letter.

 

DMC Sinai-Grace decreased average length of stay in its emergency department by nearly one hour over a six-month period. St. Joseph Mercy Oakland decreased ambulance diversion hours from 41 to zero in a four-month period and cut the percentage of patients who left its ED without being seen from 4 percent to 1 percent. Ambulances are diverted from EDs because of overcapacity issues. McLaren Macomb reduced the average time between patients’ arrival in its ED to admission by 19 minutes.

 

“Southeast Michigan is in the forefront of improving health care nationwide, and we are delighted to have these three hospitals join us,” said Lisa Mason, the Greater Detroit Area Health Council’s vice president of cost quality. “These hospitals have shown that real progress can be made in our community when you combine a culture of change with teamwork and a willingness to share.”