Measuring Quality and Implementing Change in Emergency Departments The Urgent Matters Learning Network (UMLN) II AHRQ Annual Meeting September 14, 2009.

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Presentation transcript:

Measuring Quality and Implementing Change in Emergency Departments The Urgent Matters Learning Network (UMLN) II AHRQ Annual Meeting September 14, 2009 Megan McHugh, PhD

UMLN II Hospitals

UMLN II Hospital Requirements Form a multi-disciplinary, hospital-wide team Select and implement improvement strategies Complete an implementation plan and monthly progress reports Participate in UMLN II meetings Field-test standard performance measures Participate in the evaluation of the strategies

UMLN II Framework

Open Bed Policy (Hahnemann) Consultation Process (Stony Brook) “Revitalizing” Fast Track (Thomas Jefferson) ESI III “Mid-Track” (Good Samaritan) Standardize Triage Process (St. Francis) ED/Inpatient Report Tool (Westmoreland) UMLN II Strategies (Examples)

(1)Evaluate the implementation of strategies to improve patient flow. (2)Advance the development of performance measurement in the ED. (3)Promote the spread of promising practices to a wider audience. UMLN II - Goals

What factors motivated, supported, or impeded the implementation of the strategies? What changes in patient flow occurred after the implementation of the strategies? What resources were used for the implementation of the strategies, and what were the associated costs? UMLN II Evaluation Questions

(1)Evaluate the implementation of strategies to improve patient flow. (2)Advance the development of performance measurement in the ED. (3)Promote the spread of promising practices to a wider audience. UMLN II - Goals

UMLN II Performance Measures Time from ED arrival to ED departure (admitted/discharged) Time to pain management for long bone fracture (admitted/discharged) Time to chest X-ray (admitted/discharged) Admit decision time to ED departure time (admitted)

UMLN II Performance Measures Time from ED arrival to ED departure (admitted/discharged) Time to pain management for long bone fracture (admitted/discharged) Time to chest X-ray (admitted/discharged) Admit decision time to ED departure time (admitted)

UMLN II - Goals (1)Evaluate the implementation of strategies to improve patient flow. (2)Advance the development of performance measurement in the ED. (1)Promote the spread of promising practices to a wider audience.

Preliminary Thoughts Hospitals frequently encounter challenges during implementation. Our ability to attribute improvement to specific interventions is limited. Implementation is time intensive.