1| Understand the Challenge
Address prolonged wait times as a signal of departmental inefficiencies that can increase patient morbidity, mortality, and frustration. On average, ED patients wait over 1.5 hours to be roomed and over 2 hours for discharge, but waits can stretch longer during emergencies, local health outbreaks or longer-than-usual “holds” on patients waiting to be admitted to a hospital bed.
Tip: Start by auditing your current wait times—arrival to triage, triage to provider, provider to discharge—to identify the longest delays. Educate your community and patients so they know that the ED is for truly emergent health issues, not for minor weekend health problems or because urgent care is closed. Encourage patients to understand their insurance coverage for options like telehealth services or urgent care.
2| Map Patient Flow
Bottlenecks in registration, triage, diagnostics, psychiatric “holds” or discharge create a ripple effect, and inefficient patient movement between these stages can exacerbate delays. Leverage data and observations to streamline patient flow—from arrival to discharge—to drastically improve care timelines.
Tip: Create innovative care tracks for emergent vs. non-emergent patients to improve throughput. Staff a “fast-track” area in the waiting room where nurse practitioners and physician assistants can assess, test, take temperatures/blood samples…even diagnose, treat and release low-acuity patients quickly. At a minimum, this approach can jumpstart preliminary assessments/tests until a treatment room opens. Reassure patients through compassionate dialogue and personal conversations: “Even if a treatment room isn’t available right now, know that we’re caring for you and looking at your test results to keep things moving so you can be treated as quickly as possible.”
3| Know Your Community
Understanding the specific profile, needs and patient population of your ED is extremely relevant. Whether a suburban community hospital, remote rural hospital or a large urban metropolitan hospital, make sure your approach to care is unbiased and addresses the patient’s specific concerns.
Tip: Build trust and support by addressing each community’s needs, whether through health education, clothing/coat drives, alternative transportation options, or easy-to-access information about other community resources for housing, veteran services, food/nutrition support, senior care and more. Reassure patients that by accessing these services, they reduce the likelihood of returning to the ED.
4| Lean into Team-Based, Personalized Care
When nurses, physicians, techs, and care coordinators communicate constantly and work as a cohesive unit, care is faster and more efficient. A senior clinician can provide oversight and guidance to the team, ensuring efficient care delivery and support.
Tip: Manage up your team throughout the shifts to avoid miscommunication, workflow slowdowns and patient dissatisfaction. Personalize care when speaking to patients by including the names of the members of the care team (e.g., “Nikki will be your nurse, and she’s amazing” or “You’re in good hands with Dr. Smith, and he’ll see you shortly”). When everyone is on the same page to personalize patient care, staff can visibly observe anxiety leaving patients’ faces.
5| Predict Demand with Staffing Models
Predictive modeling can help anticipate peak volumes and peak times, track fluctuations in patient volume and patient arrivals, and ensure appropriate staffing levels—reducing bottlenecks during high-demand hours
Tip: Use historical data to identify high-volume days and then proactively schedule additional hospital staff to ease the load and fill gaps.
6| Communicate Wait Times Transparently
Patients appreciate honesty and frequent updates, so address the “elephant in the waiting room” if delays are long.
Tip: During excessive delays, provide regular estimates of “when you’ll be seen” from the reception desk to manage anxiety and ease expectations. Begin assessing and screening patients in the waiting room, starting with those who have been waiting longest. Explain the delays, explain why other patients who arrived later might be seen earlier, and reassure patients that you’re treating them if they’re not in a treatment room. Doing so reduces frustration, builds trust and improves satisfaction scores.
7| Engage Patients as They Wait
While providing timely updates, make patients feel that their opinion matters and that they’re part of this medical visit.
Tip: When patients are assigned a treatment room, the doctor should reassess them (especially if they’ve been waiting long) to explain the testing, diagnosis and treatment plan in layman’s terms, and ask if they agree with the plan. Doing so sets expectations, reassuring patients that their concerns have been addressed, their needs have meet met and that they’re part of the treatment plan.
8| Engage Employees as Part of the Solution
Go beyond patient engagement. Make sure each ED team member feels valued and seen.
Tip: Offer recognition programs (e.g., candygrams, employee-of-the-week shout-outs, gift cards, awards, etc.) for ED staff members who receive positive patient feedback or go above and beyond to support compassionate, expedited care.
9| Be Thorough, Innovative and Treat All Patients with Respect
One of the best ways to ensure patient compliance and reduce return visits is to excel in provider-patient communication and focus intently on providing excellent patient care.
Tip: For each patient encounter, be engaging, personable, informative and focus on a great bedside manner. Create an authentic personal connection with each patient, an intentional practice that has a higher likelihood of the patient following the recommended treatment plan and/or taking the prescribed medicines —while reducing the likelihood of a return visit.
