To improve access and flow, the Children’s Hospital Colorado, Anschutz Emergency Department team redesigned the front end which introduced Care Progression Chairs, vertical care,

Children’s Hospital Colorado, Anschutz Emergency Department

standardized roles and earlier assessment and treatment without adding staff or space. Following implementation, roomed-to-disposition time decreased from 88 to 75 minutes for all intake patients, and from 152 to 77 minutes for “Super Track” patients. The length of stay fell 30 percent overall and 48 percent for Super Track patients. Across the ED, arrival-to-provider time decreased 37 percent, the left without being seen rate fell by 49 percent and 72-hour return visits remained stable – demonstrating faster access and improved throughput without compromising safety.

The team at the 52-bed ED also strengthened behavioral health patient safety through standardized suicide-risk screening, trauma-informed de-escalation and the Safety Care Fidelity Program. Employing “Plan Do Study Act” methodology, EHR decision support, a discharge hard stop and patient self-screening by iPad increased depression and suicide-screen completion from approximately 69 percent during pilot testing to 82 percent after implementation and a sustained 95 percent. In parallel, recurring unit-based coaching improved fidelity with two-person physical holds from “red status” – fewer than 50 percent – to green status – more than 75 percent – within the first 10 weeks, which improved team coordination and preparedness while supporting restraint reduction and safer care for patients and staff.