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Optimizing the Emergency Department at the Flevoziekenhuis hospital

The growing number of patients, shortage of staff and limited space at the Emergency Department (ED) of the Flevoziekenhuis hospital cause a high perceived work pressure and a full ED during peak times. The Philips consulting team gave the Flevoziekenhuis in Almere, the Netherlands advice and support regarding these challenges. 

The Philips team uncovered all the data needed to improve my department."

ED Chairman Dr. F. Roodheuvel

Flevoziekenhuis

flevoziekenhuis ed video
47 triage speed icon for web
1 fewer icon for web
3 minutes icon for web
50 unnecessary referrals icon for web
100 compliance handovers icon for web
34 triage effectiveness icon for web

The Challenge

 

Like other Emergency Departments in the Netherlands, the Flevoziekenhuis ED is facing several challenges. There are large numbers of patients at peak times, it is difficult to find sufficiently qualified staff, the space in the ED is limited and the patient flow is slowed down by wait times for nurses, treatment beds, examinations, physicians and intake beds. The staff is able to meet the care demand during the majority of the week; however, at busy times, it isn’t always feasible to treat all patients within a short time frame. In the worst cases, the ED has to stop accepting ambulances for a few hours — a situation that also occurs regularly in other EDs in the Netherlands. Philips was asked to optimize the department’s processes in order to meet the care demand more effectively at busy times. The second request was to address the ED space by creating an internal relocation or renovation plan.

Our Approach


The Philips consulting team followed the following customized approach for the Flevoziekenhuis hospital: 

 

  1. Root cause analysis based on quantitative data, observations and interviews
  2. Co-creation with staff to identify improvement initiatives
  3. Implementation of improvement initiatives
  4. Securing of results and continuous improvement

The Solution

 

Philips started with a detailed root cause analysis to determine the causes of closures, slow throughput and perceived work pressure. The team then grouped the causes and worked with the ED staff to identify nine improvement initiatives. Three of the initiatives were, the introduction of the new role of Triage Assistant,  the restructuring of the handover process and an internal relocation to better utilize the available space. The Philips team was closely involved throughout the implementation of  the nine improvement initiatives.  The co-creation approach contributed to lasting changes. The results were measured using key performance indicators.

Improvement initiatives

The Results*

 

Three months after the improvement initiatives were implemented, the results were measured and compared against the baselines. The key results are:

 

  • 47% improvement in triage speed
  • 1 fewer intake call
  • 3 minutes instead of 32 in patient transfer 1
  • 50% fewer unnecessary referrals
  • nearly 100% compliance of handovers
  • 34% improvement of triage effectiveness

The Philips team constantly adapted with the department during the implementation phase."

ED Chairman Dr. F. Roodheuvel

Flevoziekenhuis

1During business hours, for specific patient groups.

*Results from case studies are not predictive of results in other cases. Results in other cases may vary.

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The ED staff at the Flevoziekenhuis Hospital provide medical and nursing care to patients with acute medical problems 24 hours a day. Approximately 24,000 patients visit this ED in Almere every year. The department is part of Spoedpost Almere, a collaboration between the Medical Clinic, Emergency Department and De Brug pharmacy.

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