A 26-year-old woman went to the emergency department complaining of shortness of breath over the previous three days that had increased in intensity (Nash & Goldfarb, 2006). The patient was at the hospital for over three hours before she was able to see a physician. The physician did a complete exam and ordered blood tests, a chest x-ray, lung scan and electrocardiogram.The patient waited for three more hours before the physician told her that he believed she had asthma and should follow up with her primary care physician. The physician also prescribed a bronchodilator.
In the time prior to this patient’s visit, the hospital had experienced a decrease with patient satisfaction, an increase in patients leaving prior to being fully evaluated, and an incident where a patient fell in the crowded waiting room. The hospital administrator wanted to make changes in the emergency department to address the issue of excessive wait times. The physician director believed that the wait times were in line with the severity and types of illnesses presented. The performance improvement director felt that measuring and benchmarking prior to making changes would be beneficial.
The hospital chose to focus on wait times, patient satisfaction with services, timeliness of initiation of care for time-sensitive patients, and return visits to the emergency