Jefferson Celebrates Year One of Groundbreaking National Quality Improvement Effort
As hospitals across the United States strive to operate efficient and effective emergency departments (EDs) in the face of
today’s increasingly strained health care environment, Thomas Jefferson University Hospital (TJUH) celebrates its early successes in Urgent Matters,
a groundbreaking effort to reduce ED overcrowding, which involves just
six hand-selected hospitals across the country, including TJUH.
“ED
overcrowding is a well-known and critical issue that hospitals need to
understand and address in order to provide the best possible emergency
care for their communities,” said Theodore A. Christopher, M.D.,
F.A.C.E.P., Professor and Chair of the Department of Emergency Medicine
at Jefferson Medical College of Thomas Jefferson University. “The
groundbreaking work we are undertaking is going to help hospitals
across Philadelphia and the country to do just that. We really are
advancing the field of emergency care for everyone.”
Overcrowding
is a problem faced by any hospital operating an ED, with the potential
for serious negative consequences for health care access, quality and
patient safety to result.Patients entering an overcrowded ED face
longer wait times for care, meaning that some leave the ED without
being seen. It also disrupts ambulance service in the region. Research
has also shown that increases in ED overcrowding are associated with
increased waiting times for painkillers and antibiotics, greater
mortality and more adverse health care events.
Recent
studies have deemed America’s hospital EDs to be at a breaking point,
weighed down by overcrowding as patient volumes have steadily
increased, while at the same time, capacity has decreased. According to
the U.S. Centers for Disease Control, from 1996–2006, the number of
annual ED visits grew from 90.3 million to 119.2 million nationally.
Meanwhile, the number of hospitals operating EDs in the United States
declined from more than 5,000 in 1991 to fewer than 4,000 in 2006. The
result was that the number of ED visits rose 32 percent, while the
number of hospital EDs across the country dropped almost 5 percent –
leaving an increasing number of patients concentrated in a smaller
number of EDs.
Urgent Matters
is an 18-month national initiative dedicated to finding, developing and
measuring the effectiveness of strategies to improve patient flow and
reduce ED crowding. It is funded by the Robert Wood Johnson Foundation
and managed by a national program office at the Center for Health Care
Quality at The George Washington University Medical Center School of
Public Health and Health Services.
The six hospitals participating in Urgent Matters
collaborate through a ‘learning network’ structure to test new ideas,
quantify results and share lessons learned. Program successes will be
shared nationwide, giving other hospitals and stakeholders concrete and
tested examples of effective promising practices and interventions that
they can adopt in their own EDs.
Other hospitals participating in Urgent Matters include:
- Good Samaritan Hospital Medical Center - West Islip, NY
- Hahnemann University Hospital - Philadelphia, PA
- St. Francis Hospital - Indianapolis, IN
- Stony Brook University Medical Center - Stony Brook, NY
- Westmoreland Regional Hospital - Greensburg, PA
Hospitals now participating in Urgent Matters are following in the groundbreaking footsteps of the first Urgent Matters
Learning Network, which provided breakthrough research on patient flow
measurement and improvement. Launched in 2002, 10 hospitals in the
original collaborative implemented rigorous performance measures,
assessed existing processes and used techniques of rapid cycle change
to improve ED throughput and output.
The current Urgent Matters
Learning Network is building upon those earlier successes to advance
the development of quality improvement performance metrics in EDs by
field-testing and evaluating industry and CMS-endorsed ED performance
measures for the first time. Working in collaboration with the U.S.
Agency for Healthcare Research and Quality (AHRQ) and the Health
Research & Educational Trust (HRET), an affiliate of the American
Hospital Association, participating hospitals will track and submit
data to HRET on two CMS measures in order to evaluate the impact and
effectiveness of those improvement strategies.
Media Only Contact:
Ed Federico
Thomas Jefferson University Hospital
Phone: (215) 955-6300
Published: 2/22/2010