How to Calculate ROI in the Emergency Department
As the door to the hospital, the patient experience in your Emergency Department has a powerful influence on the community's perception of the care you provide, which drives volume through positive word-of-mouth. And, since 42% of patients discharged from federal, short-term general hospitals were admitted through the ED in 20067, ED patients fill inpatient beds.
A recent report on patient satisfaction by Press-Ganey8 noted that the average wait time for an ED patient was 4.2 hours for a single visit. And yet, patients do not feel well-informed about delays. Since well-informed ED patients are more likely to recommend a hospital (according to the study), efficiency and communication in the ED are key areas of opportunity.
The good news: The same tools and tactics that improve ED efficiency and patient satisfaction also save money and boost revenue by reducing nurse turnover, better capturing patient revenue at registration, and reducing Left Not Seen patients.
Here's how to calculate return on investment for these initiatives and a few words about the tools and tactics to get them. (For complete details about Studer Group tools, search on key words in the "Tools to Use" section below at www.studergroup.com.
Studer Group coach Julie Kennedy, RN has 17 years of clinical experience as an emergency department trauma nurse and a solid track record of hardwiring results at EDs nationwide. She is also faculty for SG's two-day Institute "Nuts and Bolts of Service and Operational Excellence in the ED."
Sample ED |
How To Calculate It |
Tools to Use |
Left Not Seen Rate |
(Beginning LNS rate) – (current LNS
rate) x annual patient volume x
average patient revenue |
Improve efficiency and keep patients informed about delays. Use “AIDET” key words, ED triage protocols, and Rapid Medical Evaluations (See page 3 for more on RME.) |
RN Turnover |
(Beginning turnover rate) –
(current turnover rate) x Total RNs
x Average RN wage |
Recruit the right nurses and retain them. Use Rounding for Outcomes, thank you notes, employee selection, 30- and 90-day new employee meetings, HighMiddleLowTM performer conversations, and Leader Evaluation ManagerSM. |
Volume Related to Patient Satisfaction |
(ED Annual volume)
x (percent volume increase)
x average patient revenue |
Build positive word-of-mouth in the community when you show you care. Use rounding in reception to reduce Left Not Seen patients. Hourly rounding and discharge phone calls build patient loyalty and referrals. |
Registration |
(Beginning number of misses)
– (current number of misses) x 12
months x average patient revenue |
Create a back-end discharge desk to ensure complete registrations and cross-check patient billing info. See Hardwired Results Issue 5. |
ED Patients Returning within 72 Hours |
(Beginning % patient returns)
– (current % patient returns) x
savings in staff time x 12 months |
Discharge phone calls improve patient compliance with physician instructions for better clinical outcomes. See Hardwired Results Issue 5. |
7 2004 National Hospital Discharge Survey, National Center for Health Statistics, May 2006
8 Press Ganey’s 2006 Health Care Satisfaction Report analyzed data for more than 1.4 million ED patients treated at 1,434 emergency departments during 2005.
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