Rethinking the ED
A HEALTHCARE DESIGN Conference panel made up of Scott Morton, vice president of project development for The Boldt Co.; Scott Lindvall, vice president and principal with HGA Architects and Engineers; Gary A. Kusnierz, vice president of performance excellence at Affinity Health System; and Kara Freihoefer, PhD, a research specialist with HGA Architects and Engineers, highlighted some of the integrated approaches that led to the creation of a universal care platform and “no-wait” emergency department (ED) at St. Elizabeth’s Hospital in Appleton, Wis. Following the motto “Pursuit of Perfection,” there was a focus on sustainability, evidence-based design, patient-centeredness, and a promise to listen to the customer.
St. Elizabeth acknowledged that there were challenges, one of which was getting people through the system so they have good access to services in a timely manner. Using a five-step continuous improvement method and “IPD-Lite”, the hospital made sure there was a common understanding of expectations for all involved in the project.
Space efficiency was achieved by co-locating like services such as the ED, surgery prep/recovery, imaging procedure, and observation. This type of platform combines patients, who have a less than 24-hour stay, in flexible private rooms that can adapt as needed. The universal care platform has 47 rooms that can flex between the departments and share staff support space according to the volume of patients. Immediate rooming for patients creates a no-wait ED and allows private rooms for every surgery prep/recovery patient for the duration of their stay.
The panel showed how metrics and a study of the ebb and flow of ED and surgery traffic were instrumental in helping to shape this universal model of care and how this contributed to the design of a no-wait ED.