Door to Doc

The Problem--Emergency departments were at capacity or beyond it, extending wait times. This resulted in a dissatisfied patient population and a patient safety issue, as many patients left before receiving treatment. One literature review study showed that 46 percent of ED patients who left without seeing a physician were judged to need immediate medical attention, and 11 percent who left were hospitalized within the next week. At follow-up, patients who left without being seen were twice as likely as those who were seen to report that their pain or the seriousness of their problem was worse.

The Problem--Emergency departments were at capacity or beyond it, extending wait times. This resulted in a dissatisfied patient population and a patient safety issue, as many patients left before receiving treatment. One literature review study showed that 46 percent of ED patients who left without seeing a physician were judged to need immediate medical attention, and 11 percent who left were hospitalized within the next week. At follow-up, patients who left without being seen were twice as likely as those who were seen to report that their pain or the seriousness of their problem was worse.

The Solution--With the help of industrial engineers at Arizona State University, Banner Health redesigned its ED flow by pioneering a process it called 'Door-to-Doc,' or D2D. The goal of D2D was to have patients see a physician sooner and free up bed space by keeping 'less sick' patients ambulatory.

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