Lyndon B. Johnson General Hospital in Houston was hit hard by Hurricane Harvey in August 2017, causing significant structural damage and increased patient demand. The hospital revamped their ED in response to these challenges and is now more efficient and safer than it was before, according to the Harvard Business Review.
Here are four lessons the hospital said it learned in the wake of the storm. .
Condense the emergency department. Though closing inpatient beds would seem to lead to congestion, the hospital found they were underutilizing inpatient clinicians who were ready to see patients. They repurposed ED treatment areas to service inpatient demands while also converting hallways into active treatment areas.
Keep patients vertical. Many ED patients do not require treatment in a stretcher or private room, so the hospital performed patient evaluations in chairs. Protocols were established to identify patients who could remain vertical and be processed more quickly.
Parallel processing is key. Patients usually stay in their bed until the care episode is completed even though they are awaiting results and do not require further treatment. The hospital moved these patients into a lower acuity setting to free up beds and lower the door-to-disposition time.
Ask for help. Though the Lyndon B. Johnson team did all they could to care for patients, if patients required an inpatient bed that simply wasn't available, the hospital wasn't afraid to transfer the patient. Since implementing these changes, the hospital has dropped ED boarding hours by 52 percent and decreased the number of patients who leave without being seen by 29 percent.
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