Mission of the ED Benchmarking Alliance: Best Practices

Organizational Objectives

• Develop a standard data set related to ED function
• Establish a database of literature on best practice administration of the ED
• Identify specific ED best practices. Definitions of a best practice are to include elements of process, outcome, effectiveness, customers, quality, cost, and speed
• Respond in a timely manner to immediate needs for ED practice information and crisis response
• Prepare programs to educate administrators, ED staff, and other medical staff physicians
• Serve as a learning organization, using references from other industries and personnel including best practice leaders in the service industry like Disney, McDonald’s, and Marriott

Response to the Mandate for Health Care Error Reduction and Efficiency

• Determination of factors associated with procedural related complications. Should we focus on patient specific factors (e.g. physiology, lab) or system/organizational factors (e.g. staffing, time of day, day of week, census, etc.)?
• Identification of factors associated with elopements and AMA's and the development of a predictive model to assess the likelihood for AMA's/elopements
• Markers of ED Efficiency: Is prolonged care in the ED an indicator of clinical excellence and economic efficiency?
• What are effective uses of the Clinical Decision Unit in the ED

Critical Operating Issues for Large Volume ED’s

• Physician Triage
• Patient Greeting and Front End Management
• Information Systems Application
• Use of Systems for Tracking and Bedside Information Exchange
• Security Issues and ED Violence
• Observation and Holding
• Patient Admitting Times Related to Overcrowding
• Critical Care Patient Interactions with Medical Staff
• Alliances with other Hospital-based groups
• Risk Management
• Patient Processing CQI
• Patient Discharge / Transfer/ “Street Ready” Evaluation
• EMS / Haz-Mat & Disaster Planning
• Exposure Control Issues
• Patient Satisfaction Studies
• Cost Effectiveness
• Use of Physicians Extenders
• Physician Orientation
• Nurse Order Entry
• EMT’s and Medical Students in the ED