These case studies were contributed by emergency departments across Massachusetts and beyond and serve as examples of innovative strategies that may help improve ED safety.

Crowding

Baystate Medical Center		Nurse flow coordinator increases efficiency and productivity
Beth Israel Deaconess Hospital–Needham		Point-of-care testing helps to expedite care and reduce emergency department wait times
Boston Children’s Hospital		A creative use of space helps meet emergency department needs and expedite care
Froedtert Hospital (WI)		Emergency department implements split-flow process to help ease crowding
Lowell General Hospital		Rapid Medical Evaluation program reduces length of emergency department stay
Massachusetts General Hospital		Home Hospital Program helps reduce ED crowding and improves the patient experience
		Using a “Capacity Physician” to find creative, collaborative solutions to overcrowding
		Using a Full-Capacity Protocol to allow inpatient floor boarding in times of peak ED capacity
Sturdy Memorial Hospital		“Quick Care” for non-emergent patients reduces wait times, improves patient experience in the ED

Baystate Medical Center		Airway carts reduce cognitive load, improve preoxygenation techniques
		Team huddles foster communication and collaboration in emergency department
Berkshire Health Systems		Wellness team helps reduce stress and fatigue, promotes mindfulness for physicians and staff
Beth Israel Lahey Health		Governance structure helps manage EHR change Clinical Informatics Committee Charter
Boston Children’s Hospital		Checklists improve success rates for high-risk, low-frequency procedures in the emergency department
Cambridge Health Alliance		Routine team huddles help improve communication and situational awareness
Lowell General Hospital		Paramedics help improve flow in emergency department
		Pediatric code carts puts essential tools at fingertips
St. Anne’s Hospital		Implementing a discharge time-out for improved safety and patient satisfaction
Sturdy Memorial Hospital		Eliminating interruptions to improve emergency care
UMass Memorial Health Care		Clinical guidelines help emergency departments provide best care possible
		Scribe program allows for more direct provider-patient care

Baystate Noble Hospital		Complex Care Team aims to reduce readmissions for high-needs patients
Beth Israel Deaconess Hospital–Milton		Strategy to reduce ED boarding of patients with behavioral health diagnoses
Beth Israel Lahey Health		Hospitals use specialized team, including pharmacists, to promote post-discharge care coordination
Boston Children’s Hospital		“Golden Ticket” dramatically improves discharge safety
Holyoke Medical Center		Investing in high-touch care coordination to reduce emergency department revisits
Massachusetts General Hospital		Post-discharge calls help improve care coordination, reduce readmissions
St. Anne’s Hospital		Implementing a discharge time-out for improved safety and patient satisfaction
Sturdy Memorial Hospital		Electronic call system helps improve post-discharge care