Improving ED Flow through the UMLN II--Thomas Jefferson University Hospital

The Problem

Inefficiencies in the fast track at Thomas Jefferson University Hospital have long been a source of frustration for ED leaders, staff and patients. Between December 2008 and February 2009, there were 1,759 fast track patients and the average length of stay was 122 minutes. ED leaders believed that they could serve these patients faster.

The Solution

Department leaders established, for the first time, a goal for fast track: patients should be discharged within 90 minutes. In order to achieve this goal, a team from the ED used the Lean methodology process to identify problems and streamline processes. The improvements included: a dedicated fast track team consisting of a nurse practitioner, nurse and tech; improved signage at the ED entrance; and readily available resources and supplies for fast track staff.