MedStar Washington Hospital Center, Washington, DC
As the largest health care provider in Maryland and the Washington, D.C., region, MedStar Health includes 10 hospitals, nine of which have emergency departments (EDs). The ED at MedStar Washington Hospital Center (Hospital Center) was like many other urban EDs across the country. Complicated work-ups and overcrowding led to long wait times for the more than 90,000 adult patients seeking treatment annually. To address this issue, in 2009 the Hospital Center embedded a “provider in triage” – known as the PIT approach – to assist patients as they entered the ED. Although PIT was not unique to the Hospital Center, the organization executed the effort with notable success. As a result, the ED staff was able to decrease “door-to-doctor” time, reduce the number of patients leaving the ED without being seen, and deliver medications to patients more quickly.