Making the ER More Like Retail

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In trying to figure out the most efficient way to run your hospital’s ER, it’s doubtful that you’ve driven past The Gap or McDonald’s and thought, “You know, maybe we should model our ER after them.”

However, the University of Colorado Hospital has experimented with this service approach in its ER to much success.

On an average day, the University Hospital will see 230 patients in its ER, Michael Booth of The Denver Post reports. Whereas before it was as packed as many ERs around the country, a recent weekday midafternoon found its “vast waiting area…empty,” and as Booth writes, “That’s just the way the design team wants it. They meticulously planned the space to employ retail magic alongside medical miracles, putting the hospital at the forefront of a national movement to deliver healthcare with industrial efficiency.”

The ER wait time used to average 80 minutes; since the University Hospital’s new ER opened in early April that time has plummeted to 10 or 15 minutes.

“Before the expansion, the hospital lost hundreds of patients a month who fled frustrating wait times without being seen,” Booth writes. “Last month, they lost none.”

Now, all a patient has to do before being swept away into quality care is receive a tracking wristband.

Booth explains, “The new space is a culmination of years of rethinking everything in the ER, using manufacturing and ergonomic tools to pull apart decades of healthcare tradition.”

And while this may be revolutionary to healthcare, it certainly isn’t revolutionary to the rest of the world, notes Dr. Richard Zane, University Hospital emergency medicine chief. “…It’s standard industry practice everywhere else.”

Some of this industrial, Gap-like efficiency includes earpiece radios and microphones for nurses and technicians, much “like those used at clothing retailers and fast-food counters”; stacked wheelchairs at the ER entrance, similar to grocery carts; computer monitors modeled after scrolling drive-through screens that list patients and their condition; and a covered and heated ER bay shaped like a semicircle so ambulances no longer have to do K-turns.

“University Hospital brags that it measures everything in its ER, and tells staff what could be better,” Booth writes. “That could wreak havoc on bedside manner, but designers say shorter waiting time is always the first demand of ER patients.”

As hospital executives, what are your thoughts on University Hospital’s retail-like approach to ER waiting times? Have you considered similar strategies for your ER? Maybe you’ve already improved your ER times. If so, what strategies worked for you?

-by Pete Fernbaugh

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