Information technology helps EDs track performance and track patient status. Overall, 40% of survey respondents expect to make ED-related IT investments over the next three years. Says Semczuk, "We collect some 40 different indicators on our ED performance. I cannot imagine managing 370,000 visits a year without having a lot of data at my disposal because, without measuring it, we can't manage it." Making decisions and providing care in such a fast-changing environment can be aided by tracking real-time status of the in-ED patient population. Says Prosser, "In our emergency room, computer screens show who's been registered but hasn't been seen. Physicians either see those people or they mark on the computer that they're the next one in."
Telemedicine is finding a place in EDs, too, with 36% expecting to invest. At Presbyterian, telemedicine helps support behavioral health assessments and diagnoses, which is significant, given that 49% of survey respondents indicate that psychiatric patients occupying beds represent a major source of ED bottlenecks. Shafer describes how telemedicine helps: "Behavioral health patients can take up a tremendous amount of time in the emergency department. You can be holding a bed for hours and hours when you haven't made a disposition, and you have to get a consult done. Finding someone to be able to do that consult can be really challenging."
Some busy EDs can remove a bottleneck if they have an in-ED pharmacy, but overall, only 11% intend to invest in an in-ED pharmacy, indicating that for many, the level of service from their existing pharmacy setup is suitable. In-ED labs (9%) and imaging (8%) have similarly low readings. Fourteen percent of those whose EDs are always or usually overcrowded intend to invest in an in-ED pharmacy, compared to 8% of those whose EDs are occasionally, rarely, or never overcrowded.
This article appears in the May 2014 issue of HealthLeaders magazine.