We are dealing with a paradox of sorts. At a time when most hospital emergency departments are dealing with issues of overcrowding and wait times in excess of an hour, we are simultaneously trying to cram more and more patients through the E.D. The idea actually makes sense to me. After all, the emergency department is the front door to the hospital; some of our clients report that as much as 60 percent of their inpatient admissions come through the E.D.

It’s the strategy that is often lacking.

The very survival of many hospitals resides in the emergency department. Drive E.D. volume, and you also drive inpatient admissions, surgical procedures, average daily census, contribution margin, and net revenue. It’s pretty simple, right?

Yes, if you have an E.D. sized and staffed for 60,000 visits per year, but currently only have half that number. That’s probably not you, is it?

Hopefully, you are not the type of organization that thinks you can simply launch a slick E.D. campaign, despite 60-minute wait times and a left-without-being-seen rate of 6%, and all your problems will be solved. To the contrary, such an approach will make matters worse, as initially more patients crowd into your already overcrowded waiting room, more patients walk out, and more patients tell their family, friends, and neighbors about their horrific experience in your emergency room.

If you want to own emergency medicine in your market, there is only one way to do it: Reduce door-to-doc time to less than 10 minutes, eliminate LWBS, and then — and only then — communicate a brand promise that cannot be matched by your competitors.

This is brand-building from the inside-out — at its best. Create a brand-busting experience first. Commuincate a brand-busting promise second.

I know what many of you are thinking right now. Door-to-doc in less than 10 minutes? Hah!

If you think this can’t be done, think again. New models of emergency care are being implemented that are completely overhauling the E.D. experience. One client, with a door-to-doc time of 47 minutes and a LWBS rate of 4%, decided on a Thursday to implement a new model the following Monday. The results were astounding: On the very first day, the door-to-doc time was eight minutes and not a single person left the E.D. without being seen. The hospital has sustained this improvement for the last two months, during which time their E.D. patient satisfaction scores have shot up from the 9th percentile nationally to the 75th percentile nationally.

At the same time, their point-of-service collections have improved, E.D. volume is on the rise, and E.D. admissions are up — and they still have yet to launch any type of E.D. campaign; this is all through word of mouth.

They are not alone. Hospitals in New Jersey, Pennsylvania, Ohio, and Florida have all recently reported similar results. So what are they all doing that is yielding these kinds of results? Eliminating nurse triage, eliminating fast-track, and moving to an immediate-bedding system that includes a rapid decision unit.

If you want to learn how to execute this kind of a brand-busting E.D. strategy, drop me a line. We also have a great little Excel app that does a thorough cost-benefit analysis of your E.D. opportunity. And it’s free for the asking.