Northwestern Medicine’s clinical operations team focuses on enhancing the care delivery model in the face of ever-present Emergency Department challenges, particularly with Emergency Department crowding and the care of vulnerable patient populations. Through redesigned patient flow, innovative programs and improved care coordination and community relationships, the operations team strives to advance the care for patients in the Chicagoland area.
The GEDI program has seen a sharp reduction in hospitalizations among older adults. In a study published in 2018, patients who had care coordinated by a TCN were admitted 36% of the time, compared to 53% of matched comparison patients who did participate in the GEDI program.
With the success of the GEDI program, Dr. Dresden was awarded an R01 in 2019 from the Agency for Healthcare Research and Quality to further study the benefits of the GEDI program for patients, including measuring the impact of GEDI on patients Health Related Quality of Life.
We're proud to be among the first Geriatric Emergency Department's in Illinois, an achievement that reflects Northwestern's commitment to providing older patients with the comprehensive, high-quality care required to meet their unique healthcare needs”
The spirit of interdisciplinary collaboration that pervades Northwestern creates a dynamic and ideal environment to conduct administrative and operational research. Current projects include:
Super Track
An evolution of the emergency department split-flow model that enables rapid treatment of patients with low-complexity conditions in virtual space, reducing waiting room crowding and improving discharge length of stay, time waiting for provider and lowering walk-out rates.
Radiology Turnaround Time Reduction
Implementation of a queuing process modeled after outpatient clinic imaging within the emergency department, involving space designation and addition of assistant technologists to reduce imaging acquisition times for patients needing X-Rays. Pilot results have shown an improvement of 15 minutes avg. for imaging start times.Boarder Care Teams
Implemented an innovative 24/7 care team for boarding patients, operationalizing a 15 bed boarder care unit staffed by physicians and advanced practice providers cross-trained in internal and emergency medicine, complete with hospital medicine nurses.
The boarder care team has resulted in hospitalized patients starting inpatient care 1.8 hours sooner on average, contributing to an additional 8 daily admissions from the ED. Collaboration with psychiatry partners is in progress to open an additional 3 beds for care of psychiatric observation patients.
Alternative Care Pathways
A comprehensive workstream targeted at reducing inpatient hospitalizations and expediting safe, effective, and patient-centered care in the ambulatory setting. Existing alternative care pathways that have led to on reductions in admissions include:Rapid Diagnostic Centers
Partnership with Immediate Care Centers, Primary Care and the Emergency Department to provide same-day extended diagnostic services in an outpatient setting.
Hospital At Home
Aims to reduce inpatient length of stay and an alternative to facility hospitalization by providing inpatient service to patients in the comfort of their own home.Team "No Bored Boarders" led by Wes Richier, including team members Emily Martin, Michelle Hill, Marie Dreyer, Jonathan Chuko with faculty support by Emilie Powell. This team's work focuses on boarding ED patients with delays in oncological patient care due to lack of heme-onc bed capacity.
Team "Focus on POCUS" led by Jim O'Brien with residents Richmond Castillo, Morgan McCarthy, Megan Chenworth with faculty support by John Bailitz. This team's work centered on increased utilization and adoption of point of care ultrasound in the ED.
Team "Fix This Sheet" with residents Adam Payne and Mitch Blenden. This team's project focused on improving medical record uploads of run sheets into for patients transported by EMS.
Team "Stroke of Genius" with residents Andrew Long, Michell Blenden and Pranav Kaul. This team's work focused on improving door to CT times for stroke patients.
Team "To the ED Boarders ICU", with residents Elizabeth Stulpin and Savannah Vogel. This team focused on improving care of boarding ICU patients with the ICU fellows.
Team "Syncope" Led by PGY3 Nick Wleklinski and PGY4 Matt McCauley, this project aims to reduce the use of echocardiograms in low-risk patients by promoting the use of the Canadian Syncope Risk Score via modifying the echocardiogram order in Epic.
Team "Recharge the Discharge" Led by PGY4 Brett Cohen, the team also includes PGY3's - David Feiger, Chloe Renshaw, Andy Rogers, and Logan Wedel. This team developed a discharge process that is stream-lined for all providers in the department and more geared towards patient satisfaction, including the implementation of "E-prescribing" to decrease pharmacy wait times for our patients