Breathalyzer Testing in Level I Trauma Center Emergency Department Improves Psychiatric Patient Length of Stay by 52 Minutes

The emergency department (ED) was experiencing extended lengths of stay for psychiatric patients, which was negatively impacting patient care, costs and throughput. These issues also impacted four of the five organizational goals, specifically those related to patient, staff and physician satisfaction and financial stewardship. Historically, the blood alcohol test was utilized in the ED, which added an average of 76 minutes to the patient throughput. The organization determined that using breathalyzers was the best option to decrease throughput time and thereby increase patient care and satisfaction. Additional education was required for physicians, outside screening consultants and potential discharge locations related to results interpretation.

The process change allowed the ED to decrease the in-process time from an average of 76 minutes to 24 minutes. Total length of stay for discharged patients was reduced by 52 minutes. This reduction in length of stay has had a positive impact on this vulnerable patient population, as patients are more quickly removed from the chaotic ED treatment environment and moved to final treatment locations.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/