Project Description

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Landlocked: Operational Changes or Build New?

The Problem

Growth in patient volume at a large tertiary hospital Emergency Department was growing faster than expected, to well over 100,000 annually, requiring the ED to “take over” adjacent space to meet capacity demands. The resulting department was a disjointed, poorly configured set of pods that created challenges for efficient operations and staffing and ability to meet the demands of the types of patients being seen. Recognizing the need for expansion, hospital leadership wanted to make sure they did not perpetuate a poor patient experience or place another Band-Aid on the already taxed department.

The Approach

Catalyst completed computer simulation modeling of the current department, testing what opportunities for process improvement could be salvaged from the choppy layout. While improvement existed, a planned surge in volume could not be accommodated. Catalyst first looked at locations on campus for a new Emergency Department. There were two options: expand in place or build new in a different spot on campus. Earlier studies of the hospital campus recommended that the Emergency Department remain in place, and a new layout was designed for the current location. However, the new layout would take as many as nine construction phases, adding cost, and up to three years of disruption before completion. Hospital leaders chose the more desirable option to build new, which was facilitated by a plan to collocate acute services in procedural and inpatient platforms.

The Solution

Using computer simulation, lean methods and computational analytics, Catalyst identified the most appropriate location to support current and future state operations, maximize patient flow, reduce the number of construction phases and cost, and lower overall organizational disruption.

Catalyst then identified the best model to optimize patient satisfaction, length of stay, outcomes, and operations in current and future states and created an action plan that could be implemented while the new department was being designed and constructed. To measure improvements, Catalyst also created a data-driven performance tracking platform so that improvements could be tracked and maintained while the new department was being constructed.

Project Details




Large Tertiary System


Emergency Department Facility and Operational Analysis

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Project Outcomes

10% increase in visits per bed.

11% improvement in ALOS.

LWBS reduced to less than 1%.

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