How Protocol-Driven Medicine Improves Emergency Department Operations

June 3, 2014  |  Delia Caldwell

Today, more and more hospitals are adopting protocol-driven (or template-driven) approaches to emergency department procedure. When an ED implements protocols effectively, these methods can dramatically improve emergency department operations and deliver care more quickly. Yet protocol-driven medicine is not a universal practice.

Why are protocols important? How does protocol-driven medicine reduce wait times? And how can departments implement protocols effectively?

Establishing a Baseline

Typically, emergency department patients don’t have a history with doctors in the ED. Since the doctor doesn’t know the patient, he/she must develop a baseline in order to deliver the most effective care. Often, establishing this baseline means ordering a predictable set of tests including chemistry and imagery.

For many circumstances and patient complaints, these tests are ordered so regularly that it is possible to identify a standardized testing regimen for the particular complaint without the direct order of a doctor. In emergency departments without protocols in place, however, patients often must wait for a doctor to become available, simply so the doctor may order these tests. Then the patient may have to wait once again while the results are processed and the physician chooses an appropriate course of treatment.

In this scenario, the doctor’s availability is an unnecessary bottleneck, extending a patient’s wait for emergency care. This delay can have serious consequences — and it is frequently avoidable.

Implementing Protocols

Protocols are written as standardized responses to common complaints encountered by the emergency department.

What does this mean for patients? Instead of waiting for a doctor to order common baseline tests, nurses may order the tests immediately according to the department’s established protocols, getting a head-start on the tests that the doctor will require. If a patient enters the ED with a respiratory complaint, nurses can have the relevant test results in hand by the time the doctor is able to see the patient — allowing the doctor to deliver the appropriate care earlier in the process.

By developing protocols internally, the emergency department can ensure that each protocol aligns with the needs and conditions of its area, as well as a given doctor’s approach.

Far from being a generic or one-size-fits-all approach, thoughtful protocols are contextually-aware and designed to facilitate faster individualized care. For hospitals seeking to enhance emergency department operations, protocol-driven medicine provides an opportunity to increase efficiency while simultaneously improving patient care and experience.

 ABOUT THE AUTHOR     Delia Caldwell MBAoutcome_swarming_Delia Caldwell
Delia Caldwell works with clinical staff to put the systems and processes in place they need to improve care and save lives. Through simulation modeling, process mapping, and dashboard tools she helps departments reduce LOS, improve patient outcomes, and streamline operations. A skilled facilitator, Delia guides organizations through change, using data to demonstrate that her recommendations will improve productivity and efficiency. With more than 85 operational studies completed, her efforts have redefined the way that providers deliver care. Read more from Delia.



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