Cleveland Clinic Marymount Hospital Emergency Department

Garfield Heights, Ohio

The Cleveland Clinic Marymount Hospital Emergency Department implemented several strategies to reduce the number of patients who leave without being seen. One key initiative, the Internal Treatment Area, allows patients to be evaluated by an emergency physician—either in person or virtually—shortly after arrival, enabling care to begin earlier in the visit. The program has evolved from a cart-mounted iPad to a grant-funded, wall-mounted monitor integrated into workflow. Since implementation, LWBS rates have decreased from 2.9 to 2.0 percent. Patient experience scores have also improved as patients have become more comfortable and familiar with virtual physician interactions.

The team also worked to reduce falls in the 30-bed ED after nursing leadership and the nursing quality program manager identified an increase in ED falls. Partnering with unit-based nurse leaders, they worked to strengthen patient safety. A Falls Prevention Team reviewed trends, completed a gap analysis and literature review and implemented evidence-based interventions. New measures included mobility team consultation, staff education on assistive devices, new stretchers with bed-exit functionality, enhanced fall-risk screening and virtual patient companions for high-risk patients. Policy and post-fall documentation were updated to better capture ED-specific risks. As a result, the ED outperformed its 2025 fall-rate benchmark target.