One of the key aspects of the initiative was having clearly defined resources allocated to the geographic space dedicated to the SuperTrack. Increasing the PCT staffing was also critical to the success.

The results of the initiative were remarkable! By December 2013, the LWBS rate had decreased to 1.4 percent, the door-to-provider times had decreased by almost a full hour (52 minutes), and patient satisfaction scores had improved. Other improvements included more efficient bed utilization, rapid room turnover, and increased nursing time with patients.

Using a new process, space, supplies, and staff dedicated to the care of very low-acuity patients, Parkland UCED improved all of its performance metrics, improved the overall flow of the department, and improved patient and staff satisfaction. I’d say this is a successful improvement initiative and that the SuperTrack is SUPER!

References

1. Grouse AI, Bishop RO, Gerlach L, et al. A stream for complex, ambulant patients reduces crowding in an emergency department. Emerg Med Australas. 2014; 26:164-169.
2. Ieraci S, Digiusto E, Sonntag P, et al. Streaming by case complexity: Evaluation of a model for emergency department Fast Track. Emerg Med Australas. 2008;20:241-249.
3. Nash K, Nguyen H, Tillman M. Using medical screening examinations to reduce emergency department overcrowding. J of Emerg Nurs. 2009;35:109-113.
4. Darrab AA, Fan J, Fernandes CM, et al. How does the fast track affect quality of care in the emergency department? Eur J Emerg Med. 2006;13:32-35.
5. Liu SW, Hamedani AG, Brown DF, et al. Established and novel initiatives to reduce crowding in emergency departments. West J Emerg Med. 2013;14:85-89.
6. Dinh M, Walker A, Parameswaran A, et al. Evaluating the quality of care delivered by an emergency department fast trackunit with both nurse practitioners and doctors. Australas Emerg Nurs J. 2012;15:188-194.
7. Welch SJ. Using data to drive emergency department design: A metasynthesis. HERD. 2012;5:26-45.

Dr. Welch is a practicing emergency physician with Utah Emergency Physicians and a research fellow at the Intermountain Institute for Health Care Delivery Research. She has written numerous articles and three books on ED quality, safety, and efficiency. She is a consultant with Quality Matters Consulting and her expertise is in ED operations.