Nashville General Hospital implements ‘No-Wait ER’ program to cut down on ER wait time

NASHVILLE, Tenn. (WKRN) — You can’t plan for an emergency; when one strikes, time is critical.

However, wait times for an emergency room visit can often be more than an hour. Not only is the wait an inconvenience, but it could mean the difference between life and death.

That difference is why Nashville General Hospital went back to the drawing board to re-examine its workflow. They came up with a new idea to improve patient care.

On any given day, the emergency room doors at Nashville General Hospital serve as a gateway.

“On average, we see 75 to 85 patients a day,” Clinical Director of Emergency Services Ashley Midkiff told News 2. “Of course, it’s an emergency department so there are always higher and lower volume days.”

The average wait time for emergency room visits in the U.S. is two hours and 25 minutes. According to reports, some states see wait times as long as four hours. 

“You can have something as small as a toothache, or as big as a gunshot wound,” Chief of Emergency Services DeAnn Bullock said. “At the same time, we are getting these people back and getting them seen.”

The CEO of Nashville General Hospital, Dr. Joseph Webb, told News 2 that once they figured out that it was a structural process issue that stood between the hospital and patients, they sought to reshape the process. That way, people could visit the hospital and know that they would not experience a delay.

Nashville General Hospital announced the ‘No-Wait ER’ program. No-Wait ER was developed to help curb the hospital’s wait times. The program did away with the traditional waiting room model, meaning that patients are immediately assessed by a triage team who swiftly prioritizes care based on the severity of the condition. 

“Whatever their challenges, whatever their barriers may be, we utilize them to really navigate through our system,” Bullock explained. “If they have to go out to another system, or resources outside of the organization, we help them navigate that. Ultimately, long-term-wise, their care is optimized so that it’s not bouncing back to the ED time after time.”

The program kicked off in April and has already seen results. According to the staff, the average door-to-bed and door-to-doctor wait times at NGH’s Emergency Department were 25 and 34 minutes respectively. Now, those same times are 4 and 5 minutes, respectively.

“The previous process is: you would get checked in and then somebody would ask you to have a seat until a triage nurse could get with you. We have eliminated that step and you’re immediately greeted by healthcare professionals,” Midkiff said. “When you decide as a patient that you’re sick enough or in enough pain that you need to go to the emergency department, you want the staff to take care of you and treat you with urgency. You want to feel like a priority, and just [by] changing our workflow, that’s what we did.”

Nashville General Hospital’s length of stay for low-acuity patients decreased by 36 percent. That represents a change from a high of 140 minutes to less than 90 minutes on average.

For more information, visit the Emergency Medicine tab of Nashville General Hospital’s website.