Using Your Data to Improve Your ED

The first, and most important, use of data is to inform the ED staff about the patients they serve and the key performance indicators for that emergency department. Table 2 is a sample staff information chart. These “patient per day” measures are the basis for effective ED management and should be posted in the staff lounge and bathroom (the most important communication site in most emergency departments). Smart ED leaders also understand what measures change on certain days (Monday in most emergency departments) and will recognize that staffing and operational changes are needed for days where predictable patient surges will occur.

Table 1: ED Performance Management Measures

Note: The definitions of these data points are in the literature.² The process for analysis of these data is summarized in an article by Shari Welch, MD, FACEP, and in ongoing Benchmarking and Special Ops articles in ACEP Now.⁴

The personnel and financial descriptors of acuity and the ED service are often shared at department meetings but not on a public chart. Those ultimately reflect on the longevity of ED managers. If ED staff and patient satisfaction are not high, a new group of managers may be analyzing the measures at future staff meetings.

The 20 numbers concept is used in other industries. The performance literature from other industries can be applied to some ED operations, but administrative decisions that affect ED performance must be driven by the demand for high-quality care and patient safety. The 20 numbers provide data to measure the successful execution of the emergency care mission. 

Table 2: A Day in Our ED

References

1. Rui P, Kang K, Ashman JJ. National Hospital Ambulatory Medical Care Survey: 2016 emergency department summary tables. 2016. Centers for Disease Control and Prevention website.
2. Wiler JL, Welch S, Pines J, et al. Emergency department performance measures updates: proceedings of the 2014 Emergency Department Benchmarking Alliance consensus summit. Acad Emerg Med. 2015:22(5):542-553.
3. 2016 National Emergency Department Inventory – USA. Emergency Medicine Network website.
4. Welch SJ, Augustine JJ, Dong L, et al. Volume-related differences in ED performance. Jt Comm J Qual Patient Saf. 2012:38(9):395-402.