Presented by: Maria Annissia Angeles,
Michele Aguilar, Jhoenalyn Mendoza, Sandra
Mendoza, Stacey Kim, & Kristine Sayavong

 600-bed public teaching hospital located in the
Boyle Heights neighborhood of Los Angeles County of California
 Jointly operated by Los Angeles County and the
University of Southern California

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 Ambulances are being diverted
 Patients are being transferred to different hospitals for better care

 Bad Patient Outcomes
 patients leave due to long patient wait-time without even receiving care
 Health complications
 ambulatory diversion results in delayed care and progressive pain and suffering
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 late diagnosis and treatment
 Death
2007: 200 emergency physicians said they’ve knew of patients who died due to long patient wait-time

 Faster and efficient care in case of an emergency
 Better and profitable healthcare services provided
 Patients receives the care that they need when they need it

• Ambulatory diversion
• Bad patient outcomes
• Health complications
• Death
Time-frame: 1-fiscal year

60
50
40
30
20
10
0
100
90
80
70

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Make sure that there is always enough staff on the schedule especially during peak times as well as always have specialist
on call so that they can come in case they are needed.
Better staff training for proper identification of patient condition, so that they can diagnose non-emergencies quickly without taking up one of the emergency beds and redirect non-emergency patients to different providers.
Make sure that the emergency room is equipped with the latest technology, enough medicine and supplies so that the
ER could work faster and more efficiently.
Other hospital policies, such as how the X-ray and lab departments prioritize patients, must be reviewed and whenever possible, aligned to meet the needs of the ER.

Cycle 4: Work with the X-Ray and lab departments and ask them to give ER patients priority to meet the needs of our department
Cycle 3: Invest in technology, more supplies, and medicine, and be able to allocate them efficiently to have enough available
Cycle 2: Better staff training to identify non-emergency patients and redirect them to other providers without taking up emergency beds
Cycle 1: Reschedule shifts to make sure the number and type of staff line up with the numbers and timing of when patients present to the ER

 Each cycle was implemented individually one after the other for a period of three months. We recorded the waiting time for each patient in the ER to get an average for each cycle.
Cycle
1
2
3
4
Average
3.5 hours
5.0 hours
4.0 hours
4.5 hours

 According to the findings, we conclude that every cycle helped reduce the waiting time in the ER significantly.
 However, the only cycle that was effective in achieving our goal was the first one by reducing the waiting time less than 4 hours.

 Since all the cycles were effective in reducing the waiting time in the ER, we are going to implement them together to have better results.
 We will keep track of the wait time average in the ER so we maintain our objective constant.

 Forming – schedule a time and day to meet up with our group and prepare a discussion
 Storming – collaboration of ideas; picking and choosing the most appropriate topic
 Norming – delegating tasks for each member
 Performing – executing tasks and meeting deadlines

 Delegation – Matching team members with tasks and explaining roles and goals
 Motivation
 Theory X and Theory Y
 Communication - You need to let your team know what's happening and keep them informed as much as possible

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Communication - lessens surprise
Sponsorship - If there is not strong leadership behind the change, resistance will keep it from happening.
Coaching - Provides hands-on help to move from A to B. Senior leadership coach management, who coaches their staff members to facilitate behavior change.
Education - Builds knowledge and ability
Understanding the resistance helps deflect the defensiveness around change, which facilitates moving ahead. When people know ahead of time, there will be less resistance than if it is forced into place in a hurry.

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Billimoria, R. (2013, February 27). Plan Do Study Act [Powerpoint slides]. Retrieved April 9, 2013, from Beachboard website: https://bbcsulb.desire2learn.com/d2l/lms/content/viewer/main_frame
.d2l?ou=182948&tId=1715355 .
Gorman, A. (2013, March 5). Officials consider adding more beds to County/USC Medical Center. Los Angeles Times. Retrieved from: http://articles.latimes.com/2013/mar/05/local/la-me-county-usc-
20130305 .
Los Angeles County & USC Medical Center. (March 2013). Retrieved
May 1, 2013 from Wikipedia: http://en.wikipedia.org/wiki/Los_Angeles_County%2BUSC_Medical_C enter .
Strategy to reduce emergency department wait times. (2012).
Retrieved April 9, 2013, from Newfoundland Labrador website: http://www.health.gov.nl.ca/health/wait_times/emergency_departmen t_strategy.pdf
.