1. ILH ED Door to Doc

2. Two Phase Improvement 1.Combine Triage and Quick Reg March 16, 2009 2.Implement ED KaT July 16, 2010

3. Before After

4. Serial to parallel

5. SMS Oct. intervals compared 117112 73 minutes medians significant Triage reg combined

6. SMS Nov. intervals compared (shows sustained for 2 months) minutes NEW DATA Not yet submitted. 96 90 70 significant Triage reg combined ED KaT

7. SMS to ED KaT Oct. comparison (arrival > triage > reg > physician) minutes

8. SMS to ED KaT Oct. comparison (arrival > reg > triage > physician) minutes medians 1440/5054

9. New Phenomena 1.Serial changed to parallel process (Quick reg. with triage) 0 minutes? Really? 2.Bedside registration

10. Results Combining registration and triage shortened some time intervals, but had no significant effect on door to doctor time. Implementation of ED KaT significantly shortened door to doc. (by 26 to 39 minutes) – (Other improvements may have had an effect. RTA, UCC) ED KaT times are longer than SMS times. – (ED KaT is probably more close to real time.) Results have sustained over at least 2 months.