Novant Health Emergency Department

Maximizing Efficiency with better Vertical and Horizontal Throughput

To create a safer ED for staff and patients that maximizes workflow, is flexible for future growth, and delivers an exceptional patient experience, we worked with Novant Health to design a new operational model that eliminates queuing and increases throughput by dividing care streams by acuity and moving non-clinical activities outside the exam room for low-acuity patients.

As a result of our Lean process, throughput per exam room increased from 1,740 visits per year to more than 5,250, an increase of 200 percent. This model also reduced “Lefts Without Being Seen” to virtually zero and reduces square footage by 20-30 percent compared to a traditional ED model.

Care streams are divided by acuity to maximize throughput.

Vertical Patients – 70% of volume

• Vertical patients include low-acuity walk-in patients
• Vertical patients use sub-waiting rooms for diagnostic procedures, results, and disposition counseling
• Maximizes throughput in treatment rooms

Horizontal Patients – 30% of volume

• Horizontal patients include emergency and high-acuity patients
• Treatment room is not released until patient discharge

Utilize Discharge (Dc) and Co-pay ($) Rooms to Maximize Throughput in Treatment Rooms