Preview: The High-Performance Emergency Department

Jim Molpus, for HealthLeaders Media , March 26, 2012

This article appears in the March 2012 issue of HealthLeaders magazine.

Editor's note: This piece is an excerpt of a fuller case study that is part of an upcoming Rounds event, Create Your High-Performance, Patient-Centered Emergency Department. To see the complete case study, which includes three additional lessons and more information, visit

The emergency department at Cambridge Health Alliance's three EDs used to be like Disney World, and not in a good way, says Assaad Sayah, MD, chief of emergency medicine and president of the medical staff. It went like this:

Wait. Wait. Wait.

Go for a short ride.

Wait. Wait. Wait.

Go for a short ride.

The herky-jerky flow of many, if not most, American hospital EDs is the natural by-product of their structure, Sayah says.

"Historically, when patients go to emergency departments, they walk in and they're confused," Sayah says. "There's nobody to talk to them. At some point somebody recognizes they're in the emergency department and then the patients go into triage. They spend time in the triage and then they go back to the waiting room. Then they go into registration after a while. Then they go back into the waiting room, and then at some point they make it inside the ED."

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1 comments on "Preview: The High-Performance Emergency Department"

Mary Guyot (3/26/2012 at 10:02 AM)
Great article and in total agreement with the process. But, there was no mention of point of service collection for patients who were at the ED for clinic level of care. How is that handled at these 3 hospitals? Unless we develop access to care at the appropriate site and expect payment when appropriate post medical screen, patients will continue to use their local ED for what could be seen in a clinic thus encouraging high cost of care and lack of accountability. I would love a response to this comment. Thank you.




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