Case Study: Guthrie Robert Packer Hospital 2024 Achievement Award

Optimal Operations—Small/Medium Division

From Solo Pitching to Calling on the Bullpen: Mitigating Left Without Being Seen Rates in Hospital Emergency Departments Utilizing a Multidisciplinary Team Approach

The Goal

The hospital was experiencing an Increased Left Without Being Seen (LWBS) rate due to increased wait times that were a direct result of boarder volumes and boarder hours. The program’s goal was to implement a multidisciplinary team triage model (MTTM), to mitigate boarded patient volumes, times, and hospital throughput barriers to better care for patients and the community.

Intervention

A multidisciplinary team was formed to review current data trends within the emergency department surrounding the LWBS rate. This team identified barriers, possible solutions, and previous interventions attempted within the department.

The team reviewed eight months of retrospective data since the prior intervention, which revealed a median LWBS rate of 4.2 percent, and a range of 3.1 percent to 5.9 percent.

This LWBS rate was seen in a department with 23,310 total emergency department visits in an eight-month period with 6,305 boarder patients, consisting of 53,967 boarder hours.

Treatment space consists of 29 walled rooms, five designated hallway spaces, three resuscitations bays, three behavioral health rooms, nine recliners result waiting spaces, three vertical treatment spaces, and one traditional triage space.

Results

In the initial eight months post intervention, the team was able to reduce the LWBS rate from 4.2 percent to 2.1 percent with a range of 1.8 percent to 2.7 percent. During December 2023, the LWBS rate was 1.4 percent.

This LWBS rate was seen in a department with 23,864 total emergency department visits in an eight-month period with 6,417 boarder patients, consisting of 53,788 boarder hours.

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Topics: Quality Initiatives

Revision Date: 2/20/2024

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