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Project Goals/Objectives Management of “Daily Surge” Preservation of Standards of Care and Patient Dignity Regulatory Compliance Differentiation from Catastrophic Surge Prevention of Non-Emergent use of Disaster Protocol Abstract When the daily demand for emergency department services is greater than a hospital's available capacity to respond, the hospital encounters surge. This project focused on improving operational resiliency during non-catastrophic daily surge at UMass Memorial Medical Center's (UMMC) emergency department. Utilizing literature review, lean methodology, and MBA coursework, this project recommends 12 best practices to improve emergency department operations at UMMC. Implementation has the potential to reduce patient length of stay up to an hour per patient, reduce the quantity of emergency department visits by up to 20%, and provide system-wide savings of over $10 million. Conclusions Acknowledgments Prof. Mustapha Fofana, WPI, MIRAD Labs Dr. Marc Gautreau, MD, UMMC Dr. Martin Reznek, MD, UMMC Ms. Gina Smith, RN, UMMC Surge Protection: Improving Operational Resiliency of Hospital Emergency Departments David Coughlin, Jesse Demers, Brian Feldman, Keith Ferry, Elizabeth Mitchell, Breanna Rinaldo Advisor: Professor Sharon Wulf, WPI Foisie School of Business Sponsor: Professor Mustapha Fofana, WPI, MIRAD Laboratories Emergency Department Process Flow Final Recommendations for UMMC: Spheres of Influence The above visual aid illustrates how our team’s recommendations align with UMMC’s emergency department’s spheres of influence. The visual starts at the core, with the emergency department itself, before expanding outwards to the entire hospital and eventually external partners and stakeholders. Recommendations with an * are considered bold or potentially high-risk, high- reward and could be considered “stretch” goals. The student team worked closely with UMMC to combine lean methodology, empirical validation, and advanced MBA coursework into an assessment of 17 different potential actions culled from an extensive literature review. The above is an aggregation of the results of the work done by the student team in collaboration with UMMC. Bars shown in color were added to the final list of recommendations for UMMC. Bars shown in gray scale were excluded for reasons such as underwhelming return on investment or having already been implemented at UMMC. To learn about how the recommended actions align with UMMC’s current environment, please refer to the exhibit “Recommendations for UMass Memorial: Spheres of Influence”. UMMC’s Assessment of Initial Recommendations Operational Regulatory Financial Business Acumen 9.8 9.6 19.9 18.9 66.0 58.8 6.6 6.7 2009 2014 2009 2014 2009 2014 2009 2014 Massachusetts National Avg Best State Worst State Emergency Departments per 1M Residents Andon Japanese for “Paper Lantern” – a visual/auditory signal or alert identifying an issue EDIE Emergency Department Information Exchange Kaizen Bursts Opportunities to eliminate waste within a given system NEDOCS National Emergency Department Overcrowding Scale PCP Primary Care Physician Application of Lean Methodologies Using this process flow map, the team identified 6 Kaizen Bursts and 17 recommendations for improvement that are applicable to the process. Initiatives that are applicable across multiple areas of the “Throughput” section were determined to have system-level applicability, and are shown as such. 311 272 176 452 Mass National Avg Best State Worst State Median ED Arrival to Departure Time – 2014 (Minutes) 306 249 674 934 1762 0 177 2009 2014 2009 2014 2009 2014 2009 2014 Massachusetts National Avg Best State Worst State Bed Surge Capacity per 1M Residents 2000+ Massachusetts Avg. ED Facts 1. Double the ED process time compared to the best state (South Dakota) 2. Half the number of EDs per resident compared to the national average 3. One quarter the hospital bed surge capacity compared to the national average 1. 2. 3. Impact Potential for UMMC 1. Patient length of stay reduction of 40 – 60 minutes (approximately 15%) 2. Emergency Department visits reduced by 8 – 20% 3. Long-term financial savings of $10 – 27 million Selection Filters
