Danbury Hospital Streamlines Emergency Patient Care

By Andrew Gorosko

In a pilot project developed by IBM and Danbury Hospital, the hospital is using digital technology to improve its emergency patient treatment efficiency, with the goal of cutting the length of patient visits at the hospital’s emergency room.

The program also seeks to streamline the hospital’s business processes and reduce costs. The project is the first effort of its kind between IBM and a hospital emergency department in the United States and is intended to achieve a safer and more efficient emergency department through improved information technology, according to IBM.

Reducing the length of emergency patient visits would allow the hospital’s emergency patient volume to increase, according to IBM. About 180 patients visit the hospital’s emergency department daily. Through increased efficiency, the hospital emergency department may be able to increase its annual patient visits from 65,000 to 72,000.

About 150 hospital staffers work in the emergency department. The 371-bed not-for-profit Danbury Hospital contains a Level II Trauma Center there. Patrick Broderick, MD, is Danbury Hospital’s chairman of emergency medicine.

Danbury Hospital is eager to use advanced technology to improve the patient flow through its emergency department, Dr Broderick said. An electronic patient tracking system has been installed for that purpose, he added.

Computer technology is being better integrated into the emergency department’s patient treatment process to eliminate repetitive steps, he said.

Currently, the average length of visits for patients who are seen by doctors in the emergency department, but who are not admitted to the hospital, is 112 minutes.

The average length of emergency department patient visits for patients who are later admitted to the hospital is 240 minutes.

Through the efficiency project, the hospital is seeking to reduce the average length of patient visits in the emergency department by 15 percent, in both cases, Dr Broderick said.

IBM has worked with various industries and with the US Postal Service to improve efficiency, the doctor said. The computer firm, which has successfully analyzed the time-and-motion aspects of industrial processes, is now applying such knowledge to improve hospital efficiency, he noted.

IBM intends to use the knowledge gained through its pilot project with Danbury Hospital to develop computer programs that could be used at other hospitals to improve the efficiency of emergency health care, Dr Broderick said.

Forward-Thinking

Noting that the Danbury area’s population continues to increase, Dr Broderick said, “It behooves us to stay forward-thinking.”

“Everybody is excited about it…We are biting at the bit to move forward on this,” he said.

IBM staffers were at the hospital from June through September 2004, working with doctors, nurses, and health technologists in analyzing the time-and-motion aspects of emergency medical care, Dr Broderick said.

Through their research, IBM staffers statistically formalized what hospital personnel implicitly knew about emergency department patient flow, Dr Broderick said. The statistical analysis of patient flow allowed an objective critique of the situation to be performed, he said.

That analysis recommended ways to improve the patient treatment process and to reduce patient waiting times, he said. Reduced waiting times tend to increase patient satisfaction, he added.

But, the doctor said, “You don’t want to sacrifice quality for speed.”

Based on the analysis of emergency department activity, the hospital decided to increase its triage nurse staffing, as needed, to reduce patient-flow bottlenecks which occur at times. Triage nurses, who have much medical experience, determine the seriousness of medical problems among those who visit the emergency department.

During busy emergency department periods, such as midday and during the dinner hour, triage nurse staffing is increased, as needed, to improve patient flow.

Also, the hospital plans to implement a bedside patient registration system, in which portable computers linked by wireless networks are rolled to the patients’ bedsides for registration, Dr Broderick said. “It is the future…to bring patient care where it needs to be.”

The overall emergency department efficiency program is expected to take about three years to implement, Dr Broderick said.

“Three years from today, we want to be 90-percent ‘paperless,’” Dr Broderick said of patient medical records.

 Having such medical records computerized increases those records’ usefulness, allowing multiple hospital staffers to use records simultaneously at multiple locations. Those records are available on about 25 computer monitors in the emergency department. 

Consolidated electronic medical information makes health care more efficient and also allows doctors to keep patients better informed, Dr Broderick said.

 The IBM research project at Danbury Hospital’s emergency department produced custom computer software that the hospital now uses to improve patient treatment efficiency, Dr Broderick said.

“We wanted to increase our capacity to serve patients…to create sound processes that reduce redundancy and prevent errors,” according to Dr Broderick.