With a beneficiary population of over 1 million, including a majority of retirees and military personnel, the Navy has made San Diego, CA the place to be.
But since the 1980’s, San Diego’s population has doubled, putting pressure on the city’s infrastructure.
One sector finding itself spread thin is the area’s medical community.
Hosting a large contingency of military and elderly patients, Naval Medical Center San Diego (NMCSD) was particularly strained.
With a facility built in the mid-1980’s (when San Diego hosted only half of its current beneficiary population), NMCSD needed to update its facilities to yield to a growing and increasingly demanding population.
The Tefen Business Consulting Firm was asked to evaluate the medical center’s emergency department to find opportunities to improve patient processing and alleviate capacity restraints. NMCSD’s largest opportunity for improvement lay with their handling of patient processing. In the ED, patients were registered before being triaged, which runs contrary to best hospital practices.
Further, instead of sorting patients by seriousness of their condition, nurses ran a full history and physical for every incoming patient regardless of symptom severity.
This extended the average triage time to about 20 minutes, well beyond the ideal two minute mark (ED wait time regularly exceeded 5 hours).
As a result, the facility experienced a high level of LWBS, or “left without being seen” patients.
Each of these challenges allowed Tefen a clear directive toward improvement of the facility.
How Tefen Helped
Tefen’s team established five levers for improvement in the medical center’s ED performance, each containing a number of supplementary recommendations. The breakdown of Tefen’s suggested levers for NMCSD are as follows:
Lever 1: Operational Efficiency
Lever 2: Practice Pattern Standardization
Lever 3: Layout & Facility Improvement
Lever 4: Staff Scheduling Optimization
Lever 5: Performance & Visual Management Systems
Performance Excellence Delivered
As a result of this diagnostic project with the Naval Medical Center San Diego, Tefen identified opportunities to streamline processes, resolve capacity restraints and improve critical key performance indicators (KPI’s) specifically within the hospital’s triage (discharge/admission) and ancillary support services sections in the emergency department.