Description:
Mease Dunedin Hospital is a 173-bed, non-for-profit community hospital located in the heart of Dunedin. FL. Mease Dunedin and its sister hospital, Mease Countryside, have been serving the greater Tampa Bay area since 1937.

Mease Dunedin is affiliated with Baycare Health System, a not-for-profit family of health care providers including nine leading hospitals in the Tampa Bay area. Baycare Health System is a member of Premier, Inc., an alliance of more than 1500 not-for-profit hospitals and health care systems comprising the largest integrated healthcare network in the United States. In May 2005, Mease Dunedin received the Premier Award for Quality from Premier, Inc., in recognition as an industry leader in congestive heart failure.

Challenge:
In order to compete with other area hospitals, Mease Dunedin needed to improve the efficiency of patient care delivered in the Emergency Room.

The 30-Minute Promise:
In conjunction with hospital administration, Dr. Oscar del Rio, Assistant Director of the Emergency Department, assembled a team of consisting of the heads of every department within the hospital. Their goal was to improve process flow to the point where patients entering the ED would be seen by a licensed health care professional such as a physician, nurse practitioner, or physician's assistant within 30 minutes.

To ensure the success of the 30-minute promise, levels of care were assessed throughout the hospital from the time a patient enters the ED until discharge. In the ED, the admission process and patient triage were streamlined, the waiting room renovated, and the method that physician's orders were written and recorded was simplified. A propos of this commitment, a sign was placed in the ED break room that reads. "We are an emergency room not a waiting room."

This activity will serve as a pilot program for similar process improvements at emergency departments at other Baycare hospitals.

Benefits Realized:
Central to the success of the program is the Nova Stat Profile Critical Care Xpress (CCX) analyzer that was installed in the ED. While the main laboratory is in close proximity to the ED and provides maintenance and regulatory support, the ED staff was trained to operate the analyzer and two nurses have been trained by Nova to serve as key operators.

According to Dr. del Rio, "prior to installation of the CCX, the turnaround time for blood gases, electrolytes and chemistry plus cardiac enzymes (troponin and CK-Mb but not myoglobin on the Biosite Triage) could run as long as 4 hours. Now laboratory testing in no longer the gating item in the ED." Further, while the expected workload was about 15 samples per day, the actual workload more than doubled due to the expedited testing program. Cost per sample was reduced to $1.70.

In 2004, the Emergency Department at Mease Dunedin treated over 25,000 patients. With the new system in place, that number rose by more than 7% in 2005.