Improving ED Flow through the UMLN II--Good Samaritan

The Problem

Good Samaritan's LWBS rate (2.1 percent) is close to the national average (2.0 percent). After reviewing their data, ED leaders found that 87 percent of LWBS patients are triaged as ESI III , and the highest LWBS rates occur among a subset of ESI III patients presenting with one of the following six chief complaints: abdominal pain, flank pain, headache, pregnancy complication, vaginal bleeding and vomiting. From December 2008 to February 2009 the ED saw 11,714 ESI III patient visits. Of these 622 (5.3 percent) were from the subset described above. The LWBS rate for the ESI III subset was 12.5 percent, compared to 3.3 percent for other ESI III patients.

The Solution

Under the Urgent Matters collaborative, Good Samaritan implemented a strategy to immediately direct a subset of ESI III patients to a dedicated physician and NP.

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