STAGE 7 SPOTLIGHT Hurley Medical Center: Solving ED Overcrowding

HIMSS Analytics

As healthcare technology evolves, providers everywhere are beginning to make strategic health IT investments to improve patient outcomes, increase operational efficiency and reduce the overall cost of healthcare — but understanding where you stand and where you have room to grow is the first and, often, most difficult step. With the HIMSS Analytics Electronic Records Adoption Model (EMRAM), providers are empowered to make these changes and drive innovation within their own organizations.

As a testament to the value of the EMRAM, let's dive into another one of our Stage 7 Spotlights with Hurley Medical Center from Genesee County, Michigan.

The Challenge

With 443 beds, Hurley Medical Center is a public teaching hospital with the region's only Level 1 Trauma Center, Level II Pediatric Trauma Center, Burn Center, and the highest level Neonatal Intensive Care Unit (NICU) in Genesee County. Hurley is a recognized leader in clinical care and education, and provides patient care to more than 100,000 people annually.

Despite their reputation, Hurley had a challenge: Overcrowding. With units consistently full and patients backed up in the emergency department, the hospital administrators needed to figure out how to increase operational efficiency and decrease the time it took to admit patients — without having to open up a new wing, unit or tower. The Hurley team knew that data such as patient volumes, acuity, admissions and discharges could help them discover opportunities for improvement in their current processes with their current resources. Rather than investing in a new wing, Hurley decided to invest in a robust EMR system.

The EMRAM Implementation

After implementing the new EMR from Epic, hospital administrators had access to more data than ever, and were able to assemble a team from multiple departments to analyze patient movement data. Initially, they aimed to identify a capacity protocol focusing on the National Emergency Department Overcrowding (NEDOC) score, a measure of overcrowding, but the overcrowding issue persisted.

The team shifted their focus to blocked beds, environmental services (EVS) turnaround times, bed assignment times and the criticality of patients to identify trends in required accommodations. They delivered a daily 28-page report with thousands of data points for their analytics committee to evaluate and understand every small nuance in patient movement from door to discharge.

The Results

Following the implementation, Hurley saw significant improvements in capacity, turnaround time and unit accommodations. Key improvements included:

  • Over the course of a year, they were able to admit 182 more patients without investing in additional beds or facilities.
  • By identifying trends in emergency room overcrowding and re-allocating staff to busier times of day, they were able to improve bed availability and reduce the average turnaround time by 12 minutes. Using data to inform their decisions, Hurley also made changes to three units to make improvements in turnaround times and further bed blocks.
  • They achieved a 20-minute improvement in bed assignment by shifting the workflow from a series of phone calls to a digital bed request and automated notifications to the receiving unit. Additionally, they integrated the EMR with Ascom VoIP telephones to send bed requests directly to the charge nurse on the receiving unit.
  • After analyzing bed block data, the team identified MRSA as the primary reason for blocked beds. After implementing a new, rapid MRSA test, the bed blocks fell from 2.5 block hours/100 census hours to their lowest point ever at 0.4 block hours/100 census hours.

The Takeaway

As Dr. Michael Roebuck, CMIO of Hurley Medical Center, said, “This is a validation of the high-tech, innovative work that we’ve done to better serve our community. We dedicate ourselves to implementing new technologies to get mission critical data in front of our clinicians to improve patient safety and outcomes. Our IT team tunes and refines our applications and our clinicians are dedicated to using the technology at their fingertips to its maximum potential.”

Like Hurley Medical Center, healthcare organizations around the world can use the EMRAM to drive innovation, increase operational efficiency and prevent costly investments when simple process changes would suffice. This is just one more example of the proven benefit of this progressive and sophisticated roadmap to EMR maturity.

case study