ED uses test site before going live

(Editor's note: This is the second article in a two-part series. In the first article, we discussed the decision of the leaders of the EDs at Sacred Heart Medical Center in Eugene, OR, to begin posting their waiting times on the Internet. In this installment, we examine the process they used to make sure the system was running smoothly before they officially started.)

Before the two EDs of the Sacred Heart Medical Center began posting their wait times on their home page, a test web site was set up for the department so that the staff could become acclimated to it and leadership could be sure everything was working correctly.

"We worked out the bugs in the system," explains Gary Young, MD, the ED medical director. For example, he says, during some of the initial trials, wait times mistakenly showed up as 1,000 minutes.

"We have RFD [radiofrequency device] badges that patients wear so we know where they are and how long they've been there," Young says. "But if the electronic system is incorrectly getting the numbers, then what we post will not be accurate."

Joy Cresci, RN, assistant administrator of emergency and critical care for Sacred Heart, says, "Our registration staff keeps the web site open, and if they see something that does not make sense, they go in and double-check on the patient. Usually what happened by mistake was that a badge was not discharged to a patient, but this hardly happens anymore."

Now that the site is up and running, the patient tracking system automatically uploads wait times every five minutes. "It would have been very different if we had to have the staff manually figure out the wait times and populate the site," notes Young, who adds that the Sacred Heart IT people had called the IT professionals at Scottsdale (AZ) Health System, which posts their wait times online, to find out how they tracked their own wait times.

Registration clerks trained

There was not much training required of the staff, except for the registration clerks, says Cresci. These clerks, who are situated in the lobby, had to learn how to monitor the web site to make sure there aren't any glitches, she says. For example, if a patient tracking badge is left in the lobby by mistake, it would continue to count as a patient. "For the rest of the staff, they just needed to know that they would be getting questions from the public," Cresci says. "Some people will still call and ask how long the wait is."

Even though wait times have gone down "dramatically," from 30 minutes to under 15 minutes, Cresci can't point to the wait time postings because many process improvement initiatives have been going on at the same time. Young says, "Psychologically, it may have had a small impact. Doctors and nurses know they're being measured and looked at by the public."

Cresci says that the charge nurses, who originally had objected to the program, "have been totally fine. They're glad we did it," says Cresci.

Sources

For more information on posting waiting times online, contact:

  • Joy Cresci, RN, Assistant Administrator of Emergency and Critical Care; Gary Young, MD, ED Medical Director, Sacred Heart Medical Center, Eugene, OR. Phone: (541) 686-7300.