For most healthcare systems, the ongoing dilemmas surrounding streamlining emergency room services are some of the most challenging in the industry today. Since ER’s can really make or break hospital’s patient satisfaction scores, and therefore, reimbursement, tackling these challenges sooner rather than later is probably in the best interest of most hospitals – one Florida hospital has already completely overhauled the concept of emergency room care through clinical operations and is now setting a high bar for ERs around the country.
Florida Hospital Tampa realized that emergency room care begins with design. When they realized that the problems stacking up against them were turning into a seemingly endless list, they took a leap of faith, trashed the old ways and redesigned the entire concept of an emergency room. Innovation isn’t cheap; this new design cost them a reported $53 million, but the Director of Emergency Medicine, Dr. Wenzel Tirheimer, felt such an expense was justified, since all the changes were made to support maximum efficiency and prioritized something that is hardly ever talked about in discussions of hospital throughput: patient comfort.
Not only was the design focus looking at physical comfort, creating spacious, considerately lit rooms, but also emotional comfort – emergency rooms are not generally calm places, but they needn’t be the pulsing, thrashing, loud and glaring ER’s portrayed on television. Most physicians, and patients, would just as well leave the “drama” to the entertainment sphere. In reimagining what an emergency room should be, Florida Hospital Tampa started by thinking about how they could transform their space to make patients comfortable – and from there, many of the other innovations, particularly those around efficiency, became abundantly clear.
How did they improve their ER?
- Focus on Patient Comfort: The first innovation wasn’t so much one of design, but of thought; instead of focusing on the building itself, or, the hospital’s needs as a place of business, Florida Hospital Tampa looked instead at what would bring the most support and comfort to their patients. They designed rooms in such a way that they were homey, spacious, comfortably lit (none of those terribly glaring overhead LEDs) and made a particularly strong effort to provide calm environments for pediatric patients. Some of the rooms have animated characters dancing around the walls with soft, colored lights that are meant to both comfort and entertain child patients. There’s also ceiling art – a trick that’s been used by dentist’s offices for years.
- No Gratuitous Equipment. Each room is also subtly different depending on the severity of the patient’s needs (minor, serious or critical) – it’s not one-size fits all, and the level of equipment is directly proportional to the level of care a patient might need. Rooms that are meant for more “basic” healthcare needs, like say, a suture or strep test, don’t have any extra equipment – that’s all reserved for the rooms set up to receive and treat trauma patients. They also boast four isolation rooms – of particular concern to hospital’s in the wake of the Ebola patients we’ve had – and also a waiting area where patients can stay while they wait for test results, which frees up room for treatment of patients who are next in line. There’s also a separate waiting area for children – with plenty of toys, activities and a much more welcoming feel than the clinical waiting rooms we’re used to.
- Triage Like You’ve Never Seen It Before. Gone are the days where you wait forever to actually see a doctor – at Florida Hospital Tampa, they’ve reimagined the triage process, too. Not all the structural changes were to physical structures. Procedural change is vital, too. Upon entering the ER, patients are immediately triaged by a physician – and then sent to one of the 48 new private patient rooms in the ER suite, based on their level of care requirements.
- Radiology Suite Specifically for ER Use One of the most vital aspects of emergency room care is timely and accurate results on tests – in many cases, this means the reading of x-rays or CT scans. With a radiology suite, and radiology staff, specifically meant for ER patients, this is likely to cut down on wait times, provide more accurate and timely readings of reports, and an overall increase in turnaround time and ER throughput.
- ER Wait-Time, Straight to Your Smartphone Actually, Florida Hospital has been doing this for a while, but their ER wait time app can help patients plan non-critical trips to the ER, decide if they should consult their primary care doctor first, or compare wait times across many urgent care centers in the Florida healthcare system. It also provides a comparative list of instances when you should choose an emergency room visit over urgent care, and vice versa. One of the ongoing challenges in managing ER throughput is the high utilization of ER services for non-emergencies, and the Florida Hospital system is combating this through education, empowerment and information – all at patient’s fingertips.
What changes has your hospital made in design or structure to help improve patient experience and ER throughput? Would you consider any of the changes that Florida Hospital Tampa has made in your facility?