At some point, most emergency physicians have wondered how their emergency departments stack up against the 4,300 others in the country. Now it’s possible to glean answers based on real data—and improve patient care and satisfaction in the process.

The Emergency Department Data Institute (EDDI) is a new data collection and analysis program from ACEP. By participating, emergency department directors, nurse managers, and CEOs will receive data on throughput, lengths of stay (LOS), volume, and resource utilization, including common drugs, tests, and procedures. They also will be able to measure and compare their departments’ performance against other emergency departments of similar sizes and characteristics nationally.

“This is a national opportunity to characterize—and measure—our practice. It is overdue. We have a tremendous chance to improve how we care for patients,” said ACEP President Nick Jouriles, M.D.

“By comparing our individual practices to those of others, we can see what we are doing well and where we can improve,” he added. “The best practices nationwide will stand out and serve as an example for others to emulate. It is another way that ACEP is helping the 120 million patients who need emergency care every year.”

Getting EDDI Off the Ground

ACEP member Dr. Rick Bukata said he has long seen the need for benchmarking in emergency medicine.

“Nurses and doctors and CEOs have a common goal of making EDs just as good and efficient as we can,” said Dr. Bukata, a clinical professor of emergency medicine at Los Angeles County/University of Southern California Medical Center and medical director of emergency services at San Gabriel Valley Medical Center. “But to do that, we need data. The idea is to try and measure this industry, compare like with like, and find the exemplars.”

For example, “everybody wants to know, ‘How long should it take to be seen? How long does it take to get through triage?’” Dr. Bukata said. “Everybody wants to know this, but nobody does know it.”

Dr. Bukata said some large hospital chains may keep such data for proprietary use, but most hospitals are unaffiliated nonprofits without access to this information. “We don’t need an outsider to measure our business,” he added. “We’re quite capable.”

In 2000, the ACEP Board of Directors convened a Benchmarking Task Force that spent the next 7 years developing the collection tools and conducted alpha and beta testing of the project in a variety of hospital settings. After a period of testing, the Board charged the College in June 2008 to develop what is now known as the EDDI.

“Quite honestly, we’re not asking the hospitals for very much in terms of their effort,” Dr. Bukata said. “We’re asking them to send us 2 days’ worth of charts each month, and to fill out a baseline and monthly surveys.”

Currently, “nobody is stripping data off charts as we’re planning to do with this project,” Dr. Bukata said. “There is no other program in the country like it. No one will have the detailed information that is available when you combine detailed staffing date, throughput data, and clinical data as will be done by the EDDI.”

What to Expect

An advisory board oversees the EDDI program. That board includes Dr. Bukata and five other emergency physicians, three emergency nurses nominated by the Emergency Nurses Association, and three hospital CEOs. A “soft launch” of EDDI was conducted at ACEP’s 2008 Scientific Assembly.

Organizers expect at least 50 decision makers for emergency departments will sign a letter of intent to participate. That’s the critical mass deemed necessary to provide meaningful data comparisons, and organizers hope that many more hospitals will enroll.

“It will allow hospitals to compare their data with like hospitals to analyze and establish baselines,” said Marilyn Bromley, R.N., ACEP’s director of practice management. The comparative hospitals will be blinded, she added.

The cost to individual emergency departments is $600 per month for participation and $4 per chart abstracted for the required 2 days per month of chart extraction (which will be completed by an ACEP-contracted vendor).

For their investment, emergency department medical directors, nurse managers, and CEOs will receive detailed monthly reports on a quarterly basis allowing them to compare and track their departments’ performance compared to similar departments. They will also benefit from EDDI analyses that identify and assist in the adoption of best practices.

Improving Patient Satisfaction

For many emergency departments, participating in EDDI costs considerably less than conducting patient satisfaction surveys, and the administrators could identify factors contributing to patient dissatisfaction—and tease out solutions, Ms. Bromley said.

“If everybody was doing just fine, it wouldn’t be necessary to do this,” Dr. Bukata said. “But for most EDs, this is a struggling endeavor.

“We know that EDs are dealing with crowding issues all the time, and patients have long wait times,” Dr. Bukata added. “This is not rocket science. If people wait hours to be seen, they’re going to be unhappy.”

To specifically address crowding, EDDI will make it possible for facilities to compare their staffing ratios and mix to see if there are ways of providing better care in less time to achieve higher levels of patient satisfaction.

“Word of mouth is an effective tool for marketing hospital services,” Ms. Bromley said, “and the ED is the ‘door’ to the hospital.”

For more information, including FAQs, a list of the monthly reports to be provided, enrollment documents, and a downloadable brochure to share with your administrators, follow the link to EDDI under “Practice Resources” at www.acep.org, or contact Ms. Bromley at mbromley@acep.org or 800-798-1822, ext. 3234.