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Posted March 05, 2018

3 Powerful Ways to Make an Impact in the Emergency Department

At The Evidence-Based Leadership Conference, healthcare professionals gathered to ask and answer questions such as: How do we innovate to change healthcare today? How can my organization succeed in these uncertain times? What can I do to improve care for my patients? During the event, Studer Group coach and emergency department (ED) nurse Angie Esbenshade, who works with emergency departments ranging from 20,000 visits a year to 150,000 visits a year across the United States and Canada, shared three tactics leaders can immediately implement to improve emergency departments.

Attendees listened closely as Angie described the chaotic environment familiar to all ED professionals. Many of us thrive on the energy of it. The differences between good and bad energy is revealed in how you answer the question: “Is it managed chaos or just chaos?”


If your ED could be described as “FRED” (frantically running every day), then throughput improvement must be a strategic priority.


Not only can emergency departments be a chaotic place, but staff including physicians are required to pivot from caring from the critically ill patient and family to caring for the most minor injury. As burnout rates rise among the care teams in the emergency department they are also faced with the growing volumes of patients and extended length of stays due to inpatient boarding. Attendees heard three powerful ways to take back control while engaging physicians, employees and patients.

Dyad Leadership – A Strong Display of Teamwork

Aligned physician and nursing leaders drive better outcomes. Build a dyad model that includes shared decision-making responsibilities and communication.

Behaviors of a good dyad model:

  • Round in the ED together
  • Share common goals
  • Communicate together, prohibit separate communications to physicians and nurses, commit to sending all communication as a joint leadership team to all team members
  • Recognize staff and providers together

Patients will receive better care when collaboration and teamwork are present.

Watch this 2-minute video clip of Angie Esbenshade as she shares the importance of dyad partnerships between physician leaders and nurse leaders.

Senior Leaders In the ED

Senior leaders can impact ED staff by showing they care, rewarding and recognizing what is working well and getting involved as part of the team. Here’s a simple win: look around and identify non-patient care issues. For example, if you notice the trash receptacles are full during a peak-volume time say, “I see the trash is overflowing. Let me get environmental services to help right away.” It is extremely important for senior leaders to acknowledge the impact that inpatient boarding has on the emergency department and communicate to that team as a senior team what steps you are doing to alleviate that burden.

Characteristics of impactful leader rounding:

  • Be visible in the ED
  • Round with ED leaders and ask them what is working well
  • Listen
  • Say “thank you”

Inpatient – ED Leader Partnerships

A strong partnership with inpatient leaders provides not only a better patient experience but also a more engaged staff.

Best practices for inpatient leaders:

  • Round in the ED on inpatient holds (Round with a charge nurse at first to build a comfort level)
  • When rounding, manage up and thank the staff currently caring for the patient
  • Let patients know what they can expect to happen next

For example, you might say, “I’m Karen, an inpatient manager here. We are working on preparing your room. In the meantime, you are getting great care in the ED.”

It is extremely important to recognize that an emergency department will not be successful without efficient operations and a focus on initiatives that help improve patient experience. To dive deeper into emergency department improvement strategies, join us at  one of our upcoming conferences on Excellence in the Emergency Department.

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