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Emergency Department Benchmarking Survey: Throughput & Productivity

  1. This survey will run for 3 months. After that time, the data will be analyzed and sent to all participants free of charge, so please remember to include your email address.
  2. Many of the questions will require you to access reports covering productivity, staffing & throughput metrics. You may print a “hard copy” of the survey to gather this data.
  3. Once you begin the survey, you cannot “pause” and return to it at a later date.
  4. Unless otherwise stated, the time period for data collection is for January – December 2008 (calendar year)
  5. No individual data will be shared, only group data.
  6. If you have questions or need clarification on the survey, you may call me at 305-495-5060 or email me at susi.holbach@hctconsulting.net

*Please fill out all fields to ensure accuracy*

Where applicable, please check off all choices that apply

<About your hospital>

(1)  Name of your Hospital:
Location of your hospital:
City:
State:


 
(2)  Is your hospital a:
 (3)  How many licensed beds does your hospital have?


<Your ED>

(4)  How many "main" beds does your ED have (excluding hall beds)? Fast Track beds/chairs are addressed in a separate question.
(5)  Do you have a "Fast Track" or non-urgent care setting in your ED?


(6)  Hours of operation for Fast Track?
Hours


(7)  Annual visits for calendar year 2008
 (8)  Average daily visits for 2008?
 (9)  Is your ED open 24/7?


(10)  Are there Community Resources within a 10 mile radius of your ED (Urgent Care, Minute Clinics, free clinics etc)?
(11)  Are you an
Are you EDAP (Emergency Dept. Approved for Pediatrics)?


(12)  What other services do you offer?
Identify


(13)  For calendar year 2008 (Jan - Dec), what % of ED patients were admitted?


(14)  For the calendar year 2008 (Jan - Dec), what percentage of the total hospital admits were from the ED?
%


(15)  Average % transferred for calendar year 2008 (Jan - Dec)?


(16)  Describe your Physician/Mid-level staffing



Productivity

Definitions:
Contracted Hours: Includes Travelers, Agency, Registry Personnel
WH/UOS: Worked hours per unit of service
UOS: Unit of service is one ED visit


(17)  How many FTEs are in the ED?

(18)  What is your budgeted or target Worked hours per Unit of Service (WH/UOS)?


(19)  What is your actual WH/UOS?


(20)  What were the total productive hours/UOS?

(21)  What was the average overtime (%) over the last 12 months?

(22)  What percentage of your overall productive hours were contract labor hours for Jan - Dec 2008?

(23)  Who is included in this WH/UOS?
Identify


(24)  Who usually provides care when "boarding" or "holding" admitted patients in the ED?
Identify


(25)  When an ED RN is the primary RN for a "boarded"/admitted patient, are his/her hours charged to the admitted floor/unit?


(26)  Do you have hospital or state mandated staffing ratios?
Hospital mandated ratio
Identify nurse/patient ratio
State mandated ratio
Identify nurse/patient ratio


(27)  During 2007 & 2008, has the volume in your Emergency Department
(Inpatient/Admitted includes patients in the Observation status)
2007 annual volume
Inpatient/admitted
Outpatient/discharged 		2008 annual volume
Inpatient/admitted
Outpatient/discharged
2007 annual volume
Inpatient/admitted
Outpatient/discharged 		2008 annual volume
Inpatient/admitted
Outpatient/discharged


(28)  What are the "usual" peak hours in your Emergency Department?


(29)  Do you experience seasonality (variance in volume depending on the season)?



Throughput


<Triage>

(30)  


(31)  Does your information system have a tracking system?

(32)  Is the Triage Area staffed 24/7?


(33)  Do you have a Tech/EMT or other personnel assist you during the Triage process:


(34)  Do your RN's use Standardized Protocols in the Triage area?


(35)  Do all patients receive a "full" triage prior to bed/chair placement in the main ED or Fast Track area (full triage defined as VS, meds, medical history, Chief Complaint, localized exam)?


(36)  Does your ED consistently practice the "Pull 'til Full" or "triage bypass" concept?


(37)  Does your ED have Mid-levels (PA/NP/FNP) in the "triage" area performing Medical Screening exams?
Hours Mid-levels provide this service (24/7, 12 hrs/day, 11a-11p)?
Electronic/paper charting?


(38)  Triage Levels


(39)  Acuity breakdown: Based on the Acuity Scale used, on average, what percent of patients are -
I - Resusitation   I - Life Threatening   I - Emergent   I - Emergent
II - Emergent II - Emergent II - Urgent II - Non-emergent
III - Urgent III - Urgent III - Non-urgent
IV - Non-urgent IV - Non-urgent
V - Referred


<Length Of Stay>

(40)  Length of Stay (LOS) for admitted patients (average) for calendar year 2008 (Jan-Dec) ?
Definition for AD LOS: From the time a patient either registers/signs-in until physically out of the ED
 


(41)  Length of Stay for discharged patients (average) for calendar year 2008 (Jan-Dec) **If you can, please exclude Fast Track patients (addressed in question below)?
Definition for DC LOS: From the time a patient either registers/signs-in until physicially out of the ED
 


(42)  Length of time in minutes (average) for calendar year 2008 (Jan-Dec) for:
Door to Triage
Triage to bed
Bed to MSE
MSE to disposition (admit, discharge, transfer)
Disposition to physically leaving the ED for:
Discharged patients
Admitted patients
Bed request to bed assignment
Bed assignment to report given (verbal or written)
Report given to patient physically out of the ED


<Fast Track>


(43)  Do you have a "Fast Track" or non-urgent care area in your ED?
If yes, hours of operation (11a - 11p, open 24 hours etc)?


(44)  Length of Stay for Fast Track discharged patients (average Jan-Dec 2008)?
  (45)  Fast Track Staffing
Identify


<Admission and Transfer>


(46)  Reasons for delays on getting admitted patients out of the ED. Please check off frequency
Waiting for consultant to call/arrive
Waiting for primary physician to call/arrive
Waiting for bed assignment (> 30 minutes)
Waiting for room/bed to be cleaned (> 30 minutes)
Waiting to give report (> 15 minutes)
Performing additional tests on the Admitted patients prior to going to a room
Unable to move admitted patient out of the ED do to the "no fly zone" (shift change)
Waiting for transportation
Within the facility
To another facility
Other


(47)  Does your ED have flow issues with moving Psych patients through your ED?


(48)  Does your ED have a Capacity Alert/Code Purple/Surge Alert/Seasonal Overcrowding Alert?
If yes, do you use it? If yes, do the appropriate personnel respond?
If no, what other measures does your ED/facility take to avoid going on diversion?
We try (mark all that apply)


(49)  On average for calendar year 2008, what is your Left Without Being Seen percentage (those patients that leave prior to a Medical Screening Exam)?


(50)  Please identify the method your ED uses to document the following (exclude "downtime" procedures):
  Manual/Paper Computer Both Computer & Paper
Patient registration
Triage documentation
Nursing assessment
Nursing interventions/orders
Nursing outcomes
Physician assessments
Physician orders
Physician disposition
Employee staffing
Lab/Radiology documentation
Charge Capture


(51)  For calendar year 2008 (Jan- Dec), did your ED go on Diversion (diversion hours defined as the inability to take any ambulance patients)?
January Hours
February Hours
March Hours
April Hours
May Hours
June Hours 		  July Hours
August Hours
September Hours
October Hours
November Hours
December Hours


(52)  Has your ED gone on situation specific diversion?


<ED Staffing Questions>


(53)  What was your RN vacancy rate in your ED for 2008?


(54)  What was your LPN/LVN vacancy rate in your ED for 2008?


(55)  What was your Tech/EMT's/Paramedics vacancy rate in your ED for 2008?


(56)   Do you have RN's, MD's, or Mid-levels that "pod" or work together as team to cover a specific area or zone in the ED?
If yes, do you have a
Identify


(57)  Does the hospital or the ED have a "patient flow coordinator" also known as a "bed czar" where the primary duty is to keep patient flow moving through-out the entire hospital and ED (nursing supervisors not included for the purpose of this survey)



(58)  Do you have dedicated Case Management in your ED (works only In the ED)?
Hours of coverage


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Full Name (required )


Phone Number

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