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.

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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

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Cognitive overload

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
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

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Care coordination

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


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