King’s Daughters Medical Center

Reduces ED LOS by One Hour Using MEDITECH Expanse

Male nurse assisting elderly in wheelchair

When King’s Daughters Medical Center staff describe the hospital and its community of Brookhaven, “family” is the word that comes up most often. Neighbors care for neighbors in this small, regional hospital, whose mission — to provide quality health and wellness in a Christian environment — resonates with every employee.

“Here at KDMC, it’s all about taking good care of people and letting them know that you care about them,” said CEO Alvin Hoover.

So when hospital leadership determined that patients were spending about 200 minutes in the ED, they knew they needed to act, and moved to get the right talent and tools in place to improve the patient experience. Within the span of a year, the ED shaved an hour off door-to-discharge times.

The impact on patient care
	ED door-to-discharge time dropped 1 hour, from 210 minutes to 151 minutes (39%).	ED door-to-doc time dropped from 38 minutes to 16 minutes (137%).	Visits beyond 6 hours plummeted from 175 to 50 (250%).	FTEs didn’t increase, despite a 15% rise in patient volumes.
Benefits felt by physicians and patients
	Expanse’s mobility makes it easier for KDMC physicians to enter orders and notes, schedule follow-ups, and view results at the point of care.

nurse and doctor visiting patient in hospital bed

A new direction

In 2016, KDMC replaced its stand-alone ED solution with MEDITECH’s integrated EHR, providing clinicians with a single patient record across inpatient and ED settings. But it was their update to MEDITECH’s web-based Expanse EHR in July 2018 that helped turn things around. This update coincided with the appointment of a new ED director, Stephen Brown, DO, who set out to shift the ED’s culture to mobile, tablet-based workflows. Dr. Brown realigned ED staffing to help drive change: three new doctors, eager to embrace the latest technologies, worked the majority of shifts.

Standard templates and canned text save time by significantly reducing screen taps. Reports that used to take 15 minutes now take two to three.

Mobility also supports the hospital’s mission of improving the quality of care in the community. Now physicians can engage with their patients the same way they do at the local hardware store — face-to-face.

“It’s very easy to take the tablet into the room and say, ‘Here’s your labs and your x-ray. We can look at this fracture right here and this is what we need to do,’” said Dr. Brown.

Integration with the acute care setting also means admitting patients from the ED is seamless.

“I’m getting great compliments from our patients,” noted CIO Carl Smith. “It takes them less time in the emergency department or upstairs to get their healthcare, and they like that.”