Regional West’s ‘ED Olympics’

Regional West’s Emergency Department Makes Measurable Improvements Through ‘ED Olympics’

Regional West’s Emergency Department Makes Measurable Improvements Through ‘ED Olympics’

Eight months ago, Regional West’s Emergency Department (ED) embarked on a mission to improve patient satisfaction, employee culture, quality measures, and overall care through an initiative dubbed the ‘ED Olympics.’ Now, they rank above the national average in almost 20 quality components from the Centers for Medicare and Medicaid Services (CMS) and organizational benchmarks and plan to continue setting goals toward further excellence.

Marisa Nicol, RN, executive director of Emergency Services, and Alice Fillingham, FNP-C, MSN, RN, CEN, the ED’s clinical coordinator, met at the end of last year to identify areas of improvement. Since the department had successfully recruited new core employees, it was the perfect time to make an action plan and get everyone on board to better the patient experience and overall care.

They began with a focus on patients who left without being seen. When they reviewed data, they found that, on average, several patients were leaving after waiting 30 to 60 minutes to be seen. In response, nurses were assigned to specific rooms to help streamline patient flow and charge nurses started calling patients who had left to check on their condition and invite them to return if they still needed medical attention.

“Our goal is to always care for each and every patient that presents to us. We just needed to find a way to do that more efficiently while still caring for the critically ill patients who were already in our rooms,” said Fillingham.

The ED team is a close-knit group and enjoys spending time together outside of work. To help engage the team and make things fun at work, Fillingham created the ED Olympics; an endeavor to improve multiple quality measures followed by emergency departments across the country. 

Every month, Fillingham posts each employee’s stats in seven core quality components and their subsets, totaling around 20 quality measures. If there was a low performer, he or she had the opportunity to improve before their numbers were released. She said that employees were excited to see the latest posts as their scores improved.

“We saw a shift in employees where they didn’t just want to be good; they wanted to be great, and they also wanted their team to rise up,” said Fillingham. “This has become a successful challenge and has had an amazing impact on our patients’ care, which is our number one focus.”

Fillingham added that it was important to establish clear expectations.

“People perform better when we are all working toward the same goals of exceptional care,” she said. “That means we needed to give employees visibility in how they were performing, tips and tools to do better, and accountability if they were falling behind on expectations.”

Once all measures achieved “gold medal status,” the ED held an Olympic event with activities such as a zipline dismount contest and paddleboard races. Since achieving these goals, the ED strives to maintain and set the bar even higher.

For many years, the department’s ‘left without being seen’ rates were above the national average of <2%. For the past five months, the department has held steady at 0.14% - a remarkable improvement. They also perform well and rank above the CMS, the American Society for Microbiology, and organizational goals in blood culture contamination rates, medication scanning, sepsis, and ED nurse overall satisfaction.

Their most recent initiative is a stroke launchpad. Through bypassing a patient room and instead using a computed tomography (CT) “launchpad”, the team is able to perform a quicker assessment and reduced the door to CT times from 20 to 30 minutes to just one to three minutes.

Both Nicol and Fillingham said these numbers reflect the ED’s ongoing commitment to improving the patient experience for the expansive region Regional West serves.

“We don’t just take care of patients from Scotts Bluff County; we care for the entire panhandle, eastern Wyoming, southern South Dakota, and northern Colorado, which includes traumas,” Nicol said. “We are here to serve everyone who comes through our doors.”