Ashtabula County Medical Center

Improving Operational Efficiency and Core Measure Compliance

Nursing Degrees The emergency department (ED) at Ashtabula County Medical Center (ACMC) has long operated as a lean organization. Ten physicians, six physician assistants and 30 nurses treat more than 34,000 Northeast Ohio residents annually. However, the ED operates with fewer physicians per shift than other larger hospitals in metropolitan areas, making operational efficiency a top priority. ACMC sought a solution that would allow clinicians to document more rapidly but without missing key information that could impact regulatory compliance, patient safety and reimbursement.

ACMC ultimately selected T Sheets, which gained fast adoption among the ED staff. Providers spent less time charting, allowing them to focus more attention on patients. The elimination of dictation reduced costs by $226,000 annually, and improved recording of IV start/stop times increased revenue by $4,000 per month. From an operational standpoint, the ED reduced the average length of stay from 2 hours and 3 minutes in 2010 to 1 hour and 51 minutes in 2011, a 9.75 percent decrease. The average door-to-doctor time decreased 57 percent, from 61 minutes to 26.2 minutes, during the same period. In addition, the left-without-being-seen rate dropped from 2.5 percent in 2009 to 0.65 percent in 2011.

By customizing the templates, the ED staff was able to better identify and thus treat certain medical conditions faster. As a result, the hospital was able to meet the requirements necessary to obtain Chest Pain Center and Heart Failure Accreditation. In addition, ACMC improved its compliance with core measures from the 72.5—94.1 percent range in 2010 to 100 percent in 2011. It also received the 2010 and 2011 Emergency Medicine Excellence Award from a leading independent healthcare ratings organization for performing in the top 5 percent in low patient mortality rates. Patients treated for emergency medicine at hospitals identified by this organization have a 40 percent lower death rate.

“Our ED team has performed better with T Sheets than we ever could have anticipated,” said ACMC ED Director Phyllis Coburn. “The awards were the first the Ashtabula community has seen of this scale, and T Sheets undoubtedly played a critical role in helping us capture core measures and improve the quality of care.”

ACMC received the 2011 T-System Client Excellence Award for Optimizing Patient Care Quality.